bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of Right-Electrocardiogram Chest Leads in Localization of Accessory Pathways in Patients with Wolf-Parkinson-White Syndrome
Authors: Ramadan Abdullah , ALtoukhy Sherif , Tawfik Mazin 
Published: August 2023

Abstract

Background
Prediction of the precise location of an Accessory Pathway (AP) prior to the ablation procedure is of clinical importance. Several algorithms have been published to localize the AP on a surface 12-lead electrocardiogram (ECG). Most of them are based on analysis of delta wave morphology or QRS polarity. However, they are somewhat complicated, and an accurate determination of the delta wave morphology or QRS polarity are occasionally difficult, and their accuracy are still limited. Recently a new published algorithm using right-sided ECG chest leads for the prediction site of an AP is figured out and still under study for measuring its accuracy.

Aim of the Work
The aim of this study is to evaluate the accuracy of the utility of rightsided ECG Chest leads in the localization of APs in patients with manifest pre-excitation pattern in 12-lead ECG in prospective manner.

Patients and Methods
This study included 35 patients in whom successful ablation of manifest Wolff-Parkinson-White (WPW) syndrome was performed in prospective manner. Standard 12-lead ECG and right-sided chest ECG waveforms were recorded before the procedure.

Results
There were 13, 10, and 12 patients with left, right, and septal APs, respectively. All left AP patients had type A (RS morphology) in V1 and 12 of them in V4R leads, only 1 had type B in V4R lead. Of the 10 right AP patients, 5 had type B (rS morphology) in V1 while all 10 patients had type B in V4R. Of the 12 septal AP patients, 9 had type C (QS or Qr morphology) in V1, while 2 of the 12 patients had type B, and 1 of 12 patients had type A. All the 12 septal AP patients had type C in V4R.

Conclusions
The QRS morphology of V1 and V4R leads could predict the site of AP in patients with WPW syndrome with overall accuracy of 85.7% and 98%, respectively.

Abbreviations
AP: Accessory Pathway; ECG: Electrocardiogram; EPS: Electrophysiology study; RF: Radiofrequency; WPW: Wolff-Parkinson-White
Impact of Sacubitril/Valsartan Combination on Prevalence of Arrhythmia in Heart Failure Patients with Reduced Ejection Fraction
Authors: Abdelsamee Ahmed M , Eldamnahoury Hayam , Allam Lamyaa , Shehata Hassan 
Published: August 2023

Abstract

Aim and Objectives
The aim of this study was to assess the effect of Sacubitril/Valsartan combination on prevalence of arrhythmias in HFrEF patients and compare it with patients on ACEI or ARBs only in addition to echo parameters follow up.

Patients and Methods
This study was conducted at Ain Shams university and Nasr city insurance hospitals and our target population was heart failure patients with reduced ejection fraction on either Sacubitril\Valsartan combination therapy (Group A) or on ACEI or ARBs (Group B) for at least 3 months, it was an observational study to follow up the burden of arrhythmia among heart failure patients by 48 hours holter monitoring at 3 and 6 months besides Echo parameters follow up.

Results
Our study included 2 groups. Group A (30 patients on Sacubitril/Valsartan combination therapy and mean age was 58.23 ± 4.80 years, 73.3% of patients were males and 26.7% females). Group B (30 patients on ACEIs or ARBs with mean age 56.37 ± 4.49 years, 80.0% of patients were males and 6 % females). There was no significant difference regarding the medical history, risk factors and NYHA classification of heart failure. The patients were classified into ischemic and non-ischemic cardiomyopathy patients and there was no significant difference between both groups. Group A was characterized by significant decrease in QTc values which reached the lowest values after 6 months, in the opposite side; group B was associated with increasing QTc values through the follow up period. As regards echocardiographic parameters we have found that left ventricle ejection fraction was improving to reach the highest values after six months in group A but we did not find significant improvement of left ventricle ejection fraction in group B. Other echocardiography parameters in group A including LA, LVIDd, RVSP and SWMA were improved by the end of the study but we have found that LA diameter was increasing in group B. In group A, burden of ventricular ectopics was found to be decreasing through the follow up period but there was no significant change of ventricular ectopics incidence in group B by the end of the study.

Conclusion
Sacubitril/Valsartan combination therapy was superior to ACEIs in reducing ventricular ectopics which means that this drug plays a role in preventing SCD. Ejection fraction in Sacubitril/Valsartan combination group was improving through the follow up period. Echocardiographic parameters were improving in Sacubitril/Valsartan group as regard LA, LVIDd and RVSP. Functional capacity in Sacubitril/Valsartan combinations group was improving through follow up period which means this drug reduces hospitalization.
The Immediate and Short-Term Outcomes of Patients with ST Elevation Myocardial Infarction with High Thrombus Burden Receiving Intracoronary Verapamil versus Epinephrine during Primary Percutaneous Coronary Intervention
Authors: Rafek Ahmed , Zahran Mohamed , Saber Mohamed 
Published: August 2023

Abstract

Background
When total coronary artery occlusion was found in the early hours of transmural myocardial infarction, most of our research interest and treatment strategies focused on epicardial coronary arteries. Little attention, however, is paid to the coronary microvasculature. When a coronary artery is occluded, detrimental changes occur in the cardiac capillaries and arterioles. After relief of the occlusion, blood flow to the ischemic tissue may still be impeded, a phenomenon known as no reflow. This abstract attempt to provide an in-depth understanding of this phenomenon and comparative review of two intracoronary agents used in no reflow settings.

Aim of the Study
This study is a comparative prospective study designed to compare between two agents‟ verapamil and adrenaline in treatment of no reflow in patients presenting with STEMI (ST elevation myocardial infarction) and a high thrombus burden developing no reflow during PPCI.

Patients and Methods
This study is a comparative prospective clinical trial designed to compare between two agents‟ verapamil and adrenaline in treatment of no reflow in patients presenting with STEMI and a high thrombus burden developing no reflow during PPCI.

Results
We have compared two of the proposed agents adrenaline and verapamil in the management of CNF and found out that verapamil is better in terms of improving LV functions but not the coronary flow. This further supported the consideration that MVO and CNF are two different entities and that we should be fully satisfied with restoration of coronary flow however all possible solutions should be spent to achieve adequate coronary perfusion so as not to give any change to MVO and microvascular dysfunction. We need a better understanding of the pathology of CNF and MVO for better solutions. It is time that we include agents more concerned with the ischemic reperfusion injury, looking at it not solely as a mechanical issue but also as an inflammatory and cellular pathology. Fighting the No reflow should be broad spectrum until such time we have a deep insight to the main pathology behind it.

Conclusion
The study concluded that the verapamil and adrenaline were not superior the standard treatment in term of TFG, but the verapamil was superior to both groups in improving the MBG while the adrenaline was not superior to the control group. The short-term outcomes were better in verapamil group than the adrenaline and control group who were equivocal.
Left Ventricular Function in Recovered COVID 19 Patients Using 4-Dimension Echocardiography
Authors: Osama Aly , Mansour Hazem , William Viola , Adel Walaa 
Published: August 2023

Abstract

Aim and Objectives
The aim of the Work was to study the effect of COVID 19 on Left Ventricular Function and dimensions using 4D Echocardiography in recovered patients

Patients and Methods
This study is a pilot study on 30 patients who are recovered from COVID19 to study LV function using 4D Echocardiography.

Results
our study showed that 50% of our patients with COVID 19 had abnormal LV global longitudinal strain.

Conclusion
In patients with COVID-19 infection, we did full study 2D echocardiography in addition to GLS & 4D echocardiography on the left ventricle and we concluded that LV global longitudinal strain was altered and it showed that 50% of our patients had abnormal LV global longitudinal strain by Speckle Tracking Echocardiography
Incidence of Documented Atrial Arrhythmias in Patients with Dual Chamber Cardiac Implantable Devices
Authors: Ellaban M , Shehata H , Katta A , Mortada A 
Published: August 2023

Abstract

Background
Atrial fibrillation (AF) is the most common sustained atrial arrhythmia, and is associated with increased risks of morbidity and mortality. Integrated management including anticoagulation therapy in patients with AF is increasingly recognized, but there are still a substantial number of AF patients admitted with stroke, heart failure, and other complications. This can be to some extent due to asymptomatic nature of AF as approximately one-third of patients did not report any symptoms commonly attributable to AF (e.g., palpitations, shortness of breath, or chest pain), leading to a prolonged delay in AF diagnosis and timely initiation of anticoagulation therapy. In many cases, asymptomatic AF is diagnosed only after the onset of complications such as ischemic stroke or congestive heart failure has occurred.

Objective
This work aims at documenting atrial arrhythmias in patients with dual chamber cardiac implantable devices.

Patients and Methods
This study included 200 patients who were undergoing follow up of dual chamber cardiac implantable devices. The study was carried out in pacemaker follow up clinics at Ain Shams University hospitals and National Heart Institute.

Results
According to the results of the current study we concluded diabetes Mellitus, ischemic heart diseases, decreased function (EF ≤ 48%) and dilated LA & LV dimensions (LVIDd &gt;48 mm, LVIDs &gt;41 mm, LA diameter &gt;52 mm), are significant factors associated with AHREs in patients with dual chamber cardiac implantable devices. But unfortunately we cannot assess precisely the impact of AHRE on stroke or thromboembolism development in such patients due to the relatively small number of patients were included in the present study, which may have reduced the detection power and possibly influenced the validity of some results.

Conclusion
Diabetes Mellitus, ischemic heart diseases, decreased function (EF ≤ 48%) and dilated LA & LV dimensions (LVIDd &gt;48 mm, LVIDs &gt;41 mm, LA diameter &gt;52 mm), are significant factors associated with AHREs in patients with dual chamber cardiac implantable devices.

Abbreviations
AF: Atrial fibrillation; AHRE: Atrial high rate episodes; AT: Atrial Tachycardia; BMI: Body mass index; CI: Confidence intervals; CIED: Cardiac implantable electronic devices; CRT: Cardiac resynchronization therapy; DDD: Dual chamber Device DM: Diabetes Mellitus; ECG: Electrocardiogram; EF: Ejection Fraction; HbA1c: Hemoglobin A1c; HR: Hazard Ratio; ICD: Implantable cardioverter defibrillator; IHD: Ischemic heart disease; INR: International Normalized Ratio; LA: Left atrium; LVIDd: Left ventricular internal dimensions (Diastole); LVIDs: Left ventricular internal dimensions (Systole); MOST: Mode Selection Trial; OR: Odds ratio; ROC: Receiver operating characteristic curve; AUC: Area Under Curve; SCAF: Subclinical AF
Correlation between Heart Rate Recovery & Global Longitudinal Strain in Heart Failure Patients Subjected to Cardiac Rehabilitation
Authors: Basem Mohamed , Kadry Ahmed , Khorshid Hazem , Samir Sameh , Mahdy Mohsen 
Published: August 2023

Abstract

Background
Cardiac rehabilitation is a medically supervised program designed to improve cardiovascular outcomes after MI, heart failure, angioplasty, or heart surgery. It is a complex intervention that involves a variety of therapies, including supervised exercise training, health education and risk factor modification, behavior change, social and psychological support.

Objective
To study the correlation between heart rate recovery & global longitudinal strain in heart failure patients subjected to cardiac rehabilitation.

Patients and Methods
This study was conducted in the cardiac rehabilitation (CR) unit in the cardiology department of Ain Shams University hospital between December 2019 and December 2020 to investigate the correlation between heart rate recovery & global longitudinal strain in heart failure patients subjected to cardiac rehabilitation.

Results
Our study is the first study that investigated the correlation between HRR and GLS in ischemic heart failure patients subjected to cardiac rehabilitation.

Conclusion
Exercise-based cardiac rehabilitation leads to improvement in the functional capacity of ischemic heart failure patients as reflected by the improvement in HRR and also leads to IMPROVEMENT in LV functions as reflected by the improvement in GLS. Moreover, METs and HR reserve was improved significantly with CR.
Role of Colchicine in Reduction of No Reflow Phenomenon in Patients with Acute ST-Segment Myocardial Infarction, Undergoing Primary Percutaneous Coronary Intervention
Authors: Sadek Nardine , Karem Khalid , William Viola , Elrahman Ahmed Abd 
Published: August 2023

Abstract

Aim and objectives
The aim of this work is to study the efficacy of colchicine administration as a preventive tool for No Reflow in patients with STEMI undergoing primary PCI.

Patients and Methods
The study included 100 patients who presented with acute STEMI to the cardiology department of Ain Shams university hospitals and underwent primary PCI (percutaneous coronary intervention). They were divided into two groups where the first group received colchicine (1 mg) besides guideline recommended therapy before primary PCI and the 2nd group served as a control group and received guideline recommended therapy. Post interventional thrombolysis in myocardial infarction (TIMI) flow grade and myocardial blush grade (MBG) were recorded.

Results
The majority of patients in both groups had the LAD as the culprit vessel for their presentation(63%). In the control group there were 19 patients with TIMI flow less than 3 and 20 patients with MBG less than 3. Meanwhile in the cases group there was 8 patients with TIMI flow less than 3 and 7 patients with MBG less than 3. This difference was statistically significant with a P value of 0.013. There were 40 patients in the cases group who received loading clopidogrel (600 mg) as premedications before Primary PCI (80%) vs 25 patients (50%) in the control group which was statistically highly significant with a P value of 0.002. In addition, Intracoronary medications (adrenaline, verapamil, tirofiban that where given during the procedure) used in 2 patients from the cases group vs 10 from the control group which was statistically significant with a P value of 0.014. There was not a statistically significant difference between the two groups regarding presenting balloon dilatation. Whereas, Post stenting balloon dilatation showed a statistically significant relationship of P value 0.014 which was done in 2 patients from the cases group vs 10 patients from the control group.

Conclusion
Colchicine loading before primary PCI resulted in improved postprocedural TIMI flow, MBG.
Cough Augmentation Techniques for Weaning in Critically Ill Patients from Mechanical Ventilation
Authors: Elassal Gehan Mohammed , El-Maraghy Ashraf , ElSheiry Eman Mosaad Saad 
Published: August 2023

Abstract

Background
Retained sputum conflicts the weaning trial, as well as increase the risk of chest infection and prolong the time on mechanical ventilation

Objective
To evaluate the impact of using mechanical exsufflators insufflators as cough augmentation technique on outcome of weaning, in addition to assessing the rate of successful weaning using NIV and T-tube mode.

Methods
A randomizes control trial that included 30 patients divided into 2 groups; the first weaned by NIV mode, the second by T-tube mode. All patients prepared equally for spontaneous breathing trial (SBT), and using ME-I frequently just before SBT.

Results
The rate of successful weaning in all cases was 66.6% (20 patients of 30), the rate was higher in groups that weaned by T-tube than NIV mode (86.67% versus 46.67%), P = 0.01. Moreover, the number of ME-I cycle was significantly higher in group with successful weaning than other group, P = 0.02.In addition, the ventilation support time was significantly longer in failed group than the successful one, P &lt; 0.001.

Conclusion
The use of MI-E just before the weaning trial enhance the outcome of weaning, moreover, the weaning trial by T-tube mode gave a higher successful rate during spontaneous breathing trial (SBT).
Study of the Correlation between CT Pattern and Clinical Presentation in Confirmed Cases of COVID-19 Pneumonia
Authors: Mostafa Kareem Y , Wagih Khaled M , Elmaraghy Ashraf A 
Published: August 2023

Abstract

Background
In Febreury, 2020 with start of COVID pandemic, chest CT outperformed lab testing in the diagnosis of 2019 novel corona virus disease (COVID-19). The researchers concluded that CT should be used as the primary screening tool for COVID-19 Early identification and treatment are therefore essential in COVID-19 management.

Patients & Methods
We Observationally collected the records of patients with RT-PCR-confirmed COVID-19 in Ain-Shams University Hospitals from 12th of June 2021 till 12th of August 2021. A total of 100 patients with consecutively laboratory-confirmed COVID-19. All patients performed HRCT chest in the time of their presentations and the different CT findings were mentioned and severity of the disease were calculated according to summation of the areas affected in different lung lobes in both lobes using the Total Severity Score and accordingly cases classified into mild, moderate and severe. All clinical data including non-respiratory & respiratory symptoms were recorded as well as oxygen saturation and correlated with CT severity.

Results
Mean age was 59.22 ±13.76 years; 65% were males and 35% were females. Non-respiratory symptoms only were present in 10 % of cases and respiratory symptoms were present in 90% of cases. The most common chest symptom was cough in 72% of our patients followed by dyspnea in 65% of them. The most common non-respiratory manifestations, were fever in 60 %, followed by fatigue in 15%, headache in 15% and diarrhea in 27% of patients. The most common CT findings were bilateral GGOs (63%), unilateral GGOs (17 %), both consolidation and GGOs (6%), while 9% had GGOs and crazy paving. According to severity index, 52 patients (52 %) were mild, 38 patients (38 %) were moderate and 10 patients (10 %) were advanced. There was a highly significant negative relation between radiological severity and oxygen saturation i.e., the more the severity score, the lower the oxygen saturation.

Conclusion
Bilateral peripheral (Ground Glass Opacities) GGO is the most common finding in COVID. CT severity score correlate significantly with Body aches, cough & dyspneawith negative correlation between CT severity score and oxygen saturation.
Value of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF) in Discriminating Candida Species
Authors: Hafez Hala M , Elanany Mervat G , Alshahat Ahmed F , Abdel Halim Rania M 
Published: August 2023

Abstract

Background
Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI TOF-MS) allows rapid and accurate identification of Candida species. Phenotypic identification of Candida species remains labor- and time consuming, and the results may sometimes be inconclusive. Rapid and reliable species identification of Candida is essential for antifungal treatment due to speciesspecific susceptibility patterns.

Objectives
We evaluated the performance of MALDI TOF-MS (VITEK MS) compared with conventional VITEK 2 YST (V2C) for identification of clinically important Candida strains.

Subject and Methods
A total of 50 Candida isolates collected from different clinical samples submitted to the Main Microbiology Laboratory Ain Shams University Hospitals, were included in this study. Candida species were identified by conventional phenotypic tests as Gram stain, culture morphology and with automated V2C panels as well as with VITEK MS.

Results
There was a total agreement of (100%) between VITEK MS and V2C at the level of the genus and (96%) at the level of the species. The most common isolates identified were C.tropicalis followed by C. albicans in urinary samles.

Conclusion
VITEK MS is a rapid and reliable method in comparison to V2C for identification of Candida strains in Microbiology Clinical Laboratory.
Neutrophil Gelatinase Associated Lipocalin: A Possible Role in β Thalassemia Syndromes
Authors: Ismail Amira Reda Mohamed , Fayek Manal Hashem , Pessar Shaimaa Abdelmalik 
Published: August 2023

Abstract

Background
Beta Thalassemia is a group of inherited blood disorders that caused by reduced or absent synthesis of the beta chains of hemoglobin resulting in variable outcomes ranging from severe anaemia to clinically asymptomatic individuals. Neutrophil gelatinase-associated lipocalin (NGAL), is a protein which is encoded by the LCN2 gene. NGAL is involved in innate immunity by sequestrating iron that in turn limits bacterial growth. It is expressed in neutrophils and in low levels in the kidney, prostate, and epithelia of the respiratory and the alimentary tracts. It also plays a key role in the physiology and pathophysiology of red blood cells, particularly in anemia.

Aim of the Work
The aim of the present work is to assess plasma level of NGAL in Beta thalassemia syndromes and correlate with laboratory hematological data and iron profile.

Patients and Methods
A Case-Control study conducted on Beta Thalassemia patients of both sexes attending the outpatient clinic of Ain Shams University Hospitals, this Pilot study of 50 previously diagnosed Beta Thalassemia patients and 30 sex and age matched healthy control subjects.

Results
The results were correlated with clinical and laboratory parameters. Comparative analysis of the results showed that all groups were homogeneous in terms of size and demographic characteristics. This can explain our results that shows that there is a highly statistically significant difference (p-value &lt; 0.001) between the cases subgroups regarding the inter-transfusion interval with longer intervals among the thalassemia intermedia subgroup. While by comparing the Hb electrophoresis parameter between the 2 groups HbA% levels were higher is the group of serum ferritin &lt;1000 ng/ml and HbF% where higher in group of serum ferritin &gt;1000 ng/ml with (p-value &lt; 0.05) for both of them. On conducting a linear regression analysis we found that the intertransfusion interval was the only independent parameter to have an effect on NGAL level on our patient group with regression coefficient -5.78 and this complies with our results of correlation between NGAL and those parameters mentioned and discussed previously.

Conclusion
The relationship between NGAL and iron level in Egyptian β-TM patients proved in our results has confirmed the proposed regulatory role played by NGAL on erythropoiesis and iron metabolism in β-thalassemia, NGAL at a cutoff value of &gt; 100 proved to be an efficient predictor of increased serum ferritin &gt; 1000 ng/ml. we believe that incorporating NGAL testing in the work up of β-TM patients in the early phases of iron transfusion dependency would provide a promising sensitive and predictive tool for early iron accumulation. We recommend further studies β-TM patients with larger samples size to clarify the co-regulatory role of erythropoiesis and iron metabolism played by NGAL.