bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stapled Cardioplasty in Management of Cardiac Achalasia
Authors: Salem Amir Hany Ali Elsayed , Fiky Khaled Abdallah El , Hefny Amr Mohamed Mahmoud El , Alsayed Mohammed Abdalmegeed , Elmoenem Ayman Hossam Eldeen Abd 
Published: August 2023

Abstract

Background
Cardioplasty is a new surgical solution for achalasia. It is done by cutting the lower oesophageal sphincter using an Endo GIA stapler and making side to side anastomosis between the lower oesophagus and the funds of the stomach.

Aim of the Work
To assess the outcome of Stapled Cardioplasty as regard improvement of the symptoms and incidence of complications.

Patients and Methods
This study was conducted at upper GIT surgery unite Faculty of Medicine, AinShams University, in the period from February 2021 till September 2021. Approval of the Ethical Committee and written informed consent from all participants were obtained. This is a prospective pilot study was conducted to assess the outcome of stapled cardioplasty. Six patients were included, four patients underwent open cardioplasty and two patients underwent laparoscopic cardioplasty.

Results
The results of this study showed a remarkable effect of cardioplasty on improvement of the symptoms of achalasia. This means cardioplasty may be a promising new option for management of cardiac achalasia.

Conclusion
Cardioplasty can be recommended as a safe and appropriate option for patients with achalasia. Albeit with limited experience, the procedure seems to provide excellent symptomatic relief and avoids the need for another intervention. It may be used as substitute of Heller myotomy as the standard treatment for achalasia in the future.
Comparison between Size of OV, Fibroscan in Chronic Hepatitis C Patients before & after Treatment with DAAs
Authors: Elsawaby Ahmed Shawky , Ibrahim Wesam Ahmed , Saleh Shreen Abo Bakr , Hasaneen Ahmed Samir 
Published: August 2023

Abstract

Background
HCV infection is a global health issue and one of the major causes of chronic liver diseases, Egypt on the top of the countries with heavy HCV burden, HCV genotype 4 is the most common in Egypt and represents 92% of total infections.

Objective
To asses changes on the size of esophageal varices and liver stiffness after treatment of HCV with DAAs.

Patients and Methods
The study was carried out at Gastroenterology and hepatology Department, Ain-Shams Hospital and Kobry-Elkoba Military Hospital and included 60 patients with chronic infection of hepatitis c virus diagnosed by (HCV Ab by ELISA positive and HCV RNA by PCR positive) and was divided into 3 groups: Group I: 20 patients chronically infected with HCV received sofosbuvir (one 400 mg tablet taken once daily) & Ribavirin (weight –related dose, 75 kg or less: 400 mg orally in the morning and 600 mg in the evening, Greater than 75 g: 600 mg orally twice daily and decrease the dose in case of anaemia) for 6 months. Group II: 20 Patients chronically infected with HCV received sofosbuvir (one 400 mg tablet taken once daily) & simeprevir (one 150 mg tab taken once daily) for 3 months. Group III: 20 patients chronically infected with HCV received sofosbuvir (one 400 mg tablet taken once daily with or without food) & daclatasvir (one 60 mg tab taken once daily) for 3 months.

Results
In the study, patients achieved high rates of SVR 12 (98.3%) only one patient at group II relapsed after finishing the treatment and did not reach SVR12. In the study, there was decrease in fibroscan stages after treatment with different regmins of DAAs, but it was significant with group III (HCV patients who received sofosbuvir & daclatasvir for 3 months). In the study, There is significant improvement in liver enzymes (AST&ALT) and significant increase at platelet count after treatment in all the 3 groups, Also there was significant decrease in hemoglobin level in group I (SOF/RIB) in comparison to other groups. In the study, there was no significant change in OV grading in group I before and after treatment, and also in group II & III only one patient in each group had changes in OV grading after treatment from OV grade III to OV grade II.

Conclusion
High rates of SVR achieved after DAAs therapy associated with significant improvement of the liver function and fibrosis regression estimated by (LSM by fibroscan) but with no improvement of the degree of esophageal varices at least in short term follow up after therapy.
Study of Risk Factors in Patient with Persistant Elevation of Liver Enzymes after Treatment of Chronic HCV by Direct Acting Antiviral Drugs (DAADs)
Authors: Salem Amira , Hamdy Hisham , Gamil Ayman , Ghobashy Asmaa Abdelraouf 
Published: August 2023

Abstract

Background
Hepatitis C virus (HCV) infection is a major global health challenge; it is estimated that more than 80 million people are chronically infected worldwide, with 3- 4 million new infections and 350000 deaths occurring each year because of HCV- related complications. Egypt is the country with the highest HCV prevalence in the world.

Aim of the Work
The aim of this study is to determine risk factors that cause persistent elevation of liver enzymes in hepatitis c virus patients treated by direct acting antiviral drugs (dyslipidemia, high BMI, type2 diabte, NAFLD).

Patients and Methods
This retrospective cross sectional study was conducted on 128 Egyptian candidates achieved SVR after 12 weeks with elevated liver enzymes before treatment by (DAAds)

Results
In this study, we found that there were correlations between the elevated ALT levels and most metabolic risk factors. There were increase in TG, BMI, and decreased. HDL-c, which were components of metabolic syndrome, were associated with high ALT levels in patients. Metabolic syndrome (MS) components are highly prevalent in NAFLD lack of biochemical response was associated with a higher risk to develop liver related complications (decompensation and cancer), indicating that these patients should undergo further hepatological followup.

Conclusion
Further large-scale studies employing larger number of patients are needed to evaluate risk factors that cause persistent elevated liver enzymes after eradication of hepatitis c viral infection with DAAds.
Patatin-Like Phospholipase Domain Containing 3 (PNPLA3) as a Non-Invasive Marker in Diagnosis of NASH
Authors: Elmagid Nanees Ahmed Adel Abd , Riad George Safwat , Hashem Walaa Mohamed , Agwa Sara Hassan , Sabry Karim , Elgohary Shimaa Abdelraouf , Bawal Bino Andrea Ahmed 
Published: August 2023

Abstract

Background
Non-alcoholic fatty liver disease (NAFLD) represents a spectrum of progressive liver disease characterized by increased hepatic triglyceride content (HTGC) in the absence of excess alcohol consumption. NAFLD includes simple steatosis, non-alcoholic steatohepatitis, fibrosis and ultimately cirrhosis, and is strongly associated with features of the metabolic syndrome (obesity, insulin resistance/type 2 diabetes mellitus and dyslipidemia).

Objective
To study the role of PNPLA3 as non-invasive biomarker in diagnosis of NASH.

Patients and Methods
Single Centre randomized case control clinical study This study was conducted for patients attended Bariatric surgery unit at Ain-Shams University Hospital. Literature review designed and data collection started in October 2019 up to March 2021. This study performed on 50 Egyptian patients, proven NAFLD by histology, patients were biopsied during a bariatric Surgery at Ain-Shams University Hospital after written consent were obtained, and 25 healthy control Subjects were selected randomly after meted the criteria.

Results
The G risk allele shows higher level of ALT and statistically significant (p &lt; 0.028*) but not significant with AST (p &lt; 0.243), significant with triglycerides (p &lt; 0.013*), with total cholesterol (p &lt; 0.010*) and BMI (p &lt; 0.016*) independent of the others parameter compared to wild type C allele. To greater number of G risk allele more higher scoring of NAS score (p &lt; 0.002*) and increasing likelihood of advance fibrosis stage (p &lt; 0.046*). By dominant analysis 54.77% of the steatohepatitis patients carrying the risk allele G while steatosis group only 22.42% carrying the risk allele the risk G allele had 4.19 fold more risk of having sheatohepatitis (NASH) than the wild type C allele among the studied NAFLD patients group (odds ratio 4.19, CI 95% 1.762-9.962, p &lt; 0.001*). Homozygous and heterozygous Risk allele GG, CG had 4.37 fold risk of developing NAFLD than the homozygous wild type CC (CI 1.491-12.826, p &lt; 0.005*) and by dominant analysis the risk G allele had 3.45 fold more risk of having NAFLD than the wild type C allele (CI 1.408-8.474, P-value &lt;0.003*) in Egyptian

Conclusion
We demonstrated for the first time risk of PNPLA3 rs738409 polymorphism in Egyptian, by dominant analysis the risk G allele had 3.45 fold more risk of having NAFLD than the wild type C allele in Egyptian, the risk G allele had 4.19 fold more risk of having sheatohepatitis (NASH) than the wild type C allele among the studied NAFLD patients group.
Relation of Growth Differentiation Factor 15 (GDF 15) to Early Diabetic Nephropathy
Authors: Seif Khaled Hussein Abou , Abouellail Hesham Atef , Said Tamer Wahid E L , Rezk Khaled Mohamed , Boktor Haron Akhnokh Haron 
Published: August 2023

Abstract

Background
Diabetic nephropathy (DN) is one of the leading causes of end-stage renal disease (ESRD) in developed countries and is becoming more prevalent globally due to the rise in the incidence of obesity and type 2 diabetes, DN is a progressive kidney disease caused by alterations in the glomerular capillary and tubular structure and function induced by the disturbed glucose homeostasis. Recent studies are conflicting regarding the sensitivity and the specificity of biomarkers currently used in practice for DN diagnosis (e.g., eGFR, albuminuria).

Aim of the Work
The aim of this work is to evaluate the relation of Growth Differentiation Factor 15 (GDF 15) to early Diabetic Nephropathy. For this purpose we study 90 adult diabetic patients classified into three groups: group (1); 35 patients with micro-albuminuria (UAE 30–299 mg/24 h), group (2); 35 patients with macro-albuminuria (UAE ≥ 300 mg/24 h), and group (3); 20 patients with norm-albuminuria (UAE &lt;30 mg/24 h). It was found that there is no statistically significant difference between age and sex in the three studied groups, so patients in this study are matched in age and sex.

Patients and Methods
This cross-sectional comparative study involved 90 adult diabetic patients were selected from the patients attending the outpatient clinic of the Nephrology Department in Hurghada General Hospital. The study was performed at the period from January 2018 to January 2019.

Results
As regard the type of diabetes in our study there was statistically insignificant difference between microalbuminuric and macroalbuminuric groups in this study as regard type 1 and type 2 diabetes. Our data revealed that there is a statistically insignificant difference between the three studied groups as regard duration of diabetes, The study also showed that there was statistically insignificant difference between the two studied groups (1 & 2) as regard hypertension, while they were statistically significant compared to controls, This study showed that GDF-15 was markedly elevated in group 1 & 2 compared to control. There was statistically very highly significant difference between the two studied groups (1 & 2) and control group (3), while there is a statistically significant difference between group 1 and group 2.

Conclusion
In conclusion, the GDF-15 levels at the time of diagnosis have a significant negative correlation with the initial renal function and a significant positive correlation with a higher risk of disease progression in DN. Our result suggested that high GDF-15 reflects early renal injury and a mild degree of proteinuria in DN. GDF-15 is independent prediction to proteinuria level.
Anti-Ficolin-2 Antibody: Could It Be a Predictor of Proliferative Lupus Nephritis in Lupus Patients?
Authors: Kamal Sylvia Talaat , Farres Mohamed Nazmy , Ibrahim Rehab Ali , Ibrahim Ibrahim Sami , Ahmed Fatma Abdelrahman 
Published: August 2023

Abstract

Background
Nephritis is a challenging domain of systemic lupus erythematosus (SLE). There is a growing need for identification of a non-invasive marker for diagnosing and monitoring nephritis.

Objective
To explore the relevance of using anti-ficolin-2 antibody (Anti-FCN2) as a biomarker for detecting lupus nephritis (LN), and its relation to renal biopsy histopathology and disease activity.

Patients and Methods
Sixty SLE patients were compared to 30 apparently healthy individuals. Thirty of the patients were LN patients (documented by a recent renal biopsy). Full history, examination and laboratory investigations were done. Activity was assessed by SLE disease activity index (SLEDAI) score, and Anti-FCN2 titer was measured by enzyme-linked immunosorbent assay technique (ELISA).

Results
Forty-four of our SLE patients were in disease activity by SLEDAI score. Anti-FCN2 titer was significantly higher among SLE patients compared to control group (p value &lt;0.001). It was also higher among patients with high disease activity compared to those with low disease activity and cutoff value was at 37 ng/ml (p value is &lt; 0.001). AntiFCN2 titer was significantly higher among patients with LN compared to those without LN (p value is &lt; 0.001) with best cutoff value at 72.50 ng/ml. Regarding LN patients, it was significantly higher among patients with proliferative changes than LN patients with non-proliferative changes (p value is 0.05) with best cutoff value at 155 ng/ml.

Conclusion
Anti-FCN2 shows promising results as a biomarker for lupus disease activity, especially regarding LN and proliferative changes. Further longitudinal studies on larger samples are needed to confirm.
Urinary Podocalyxin Is an Early Marker for Podocyte Injury in Patients with Diabetic Nephropathy as well as Other Glomerular Disease
Authors: Ibrahim Khaled Mahfouz Abdel Naim , Ahmed Yasser Suleiman , Salman Manal Ibrahim Mohammed , Bashary Walid Ahmed , Hussein Hussein Sayed 
Published: August 2023

Abstract

Aims/Objective
Nephropathy, a major complication of diabetes, is the leading cause of end-stage renal disease. Recent studies have demonstrated that podocyte injury is involved in the onset of and progression to renal insufficiency. Here, we describe a novel, highly sensitive ELISA for detecting urinary podocalyxin, a glycoconjugate on the podocyte apical surface that indicates podocyte injury, particularly in the early phase of diabetic nephropathy.

Methods
Urine samples from patients with glomerular diseases (n = 40) and diabetic nephropathy (DN) (n = 40) subdivided into 2 groups (DN with macroalbuminuria (n = 20) and DN with microalbuminuria (n = 20)) were used to quantify urinary podocalyxin by ELISA. Urine samples were obtained from 20 healthy controls for whom laboratory data were within normal values. Podocalyxin was detected in urine by ELISA.

Results
urinary podocalyxin.detective range was 0.156-10 ng/mL, Levels of urinary podocalyxin were elevated in patients with various glomerular diseases and patients with diabetic nephropathy. level of urine podocalyxin was significantly positively correlated regarding LDL cholesterol and urine protein in all patients group, patients with glomerular diseases and patients with DN, while urine podocalyxin was significantly positively correlated regarding diastolic BP, HbA1c in all patients group but neither in patients with glomerular diseases nor patients with DN, while urine podocalyxin was significantly positively correlated regarding CRP in all patients group but in patients with DN it was significantly negatively correlated.while it was not significantly correlated in patients with glomerular diseases. No significant correlation between urine podocalyxin and pathology in renal biopsy.

Conclusions/interpretation
the level of urinary podocalyxin could provide information of earlier glomerular impairment in patients with Glomerular diseases and diabetic nephropathy and can be used as earlier marker for Glomerular diseases and diabetic nephropathy like microlbuminuria.
The Effect of Sodium Bicarbonate Supplementation on Serum Alpha Klotho in Chronic Kidney Disease Patients Stage 3b to 4
Authors: Shinnawy Howayda Abdel Hameed El , Khedr Lina Essam , Abdel-Samea Marwa Shaaban , Ibrahim Mahmoud Rabie 
Published: August 2023

Abstract

Background
Growing evidence suggests that the FGF–Klotho endocrine system also has a crucial role in the pathophysiology of ageing-related disorders, including diabetes, cancer, arteriosclerosis and chronic kidney disease.

Aim of the Work
The present study aimed to ascertain the potential significance of oral sodium bicarbonate supplementation on soluble α-Klotho serum levels in chronic kidney disease (stage 3b:4) according to CKD-EPI formula.

Patients and Methods
This was an uncontrolled clinical trial conducted on Inward and OPC patients at El-Demerdash Internal Medicine Hospital. The baseline values of plasma α-klotho were measured in 45 patients having CKD with an estimated glomerular filtration rate (eGFR) of (15:44) mL/min/1.73 m2 (according to CKD-EPI formula) with follow up plasma α-klotho after 3 months of taking sodium bicarbonate tabs orally 0.5 g/12 hrs.

Results
In our study, 14 (Fourteen) patients with Hypertension, 13 (Thirteen) patients Diabetes, 6 (Six) patients Glomerulus's nephritis, 6 (Six) patients Repeated urinary tract infection, 4 (Four) patient Recurrent stones, 4 (Four) patient Polycystic kidney and 2 (Two) patient Systemic lupus. The Klotho (pg/mL) Before ranged from 296.7 to 976.5 with mean 596.30 ± 202.89 and the Klotho (pg/mL) After ranged from 327.4 to 988.6 with mean 696.16 ± 185.32. The Hco3 before ranged from 17.6 to 22.5 with mean 19.74 ± 1.43 and the Hco3 After ranged from 15 to 28.3 with mean 23.63 ± 3.23. The current study showed that there was non statically significant correlation Between Klotho (pg/mL) and SPB, DPB, Pulse, Temperature, Respiratory rate. The present study showed that there was non statically significant correlation Between Klotho (pg/mL) and Platelets, Urea, Creat, U. creatinine, U. albumin, A/C Ratio, E-GFR, Na, K, Ca, Po4. There was Non statically significant correlation Between Klotho (pg/mL) and Hco3 Before, and there was statically significant Positive correlation Between Klotho (pg/mL)After and Hco3 After.

Conclusion
There was highly significant difference found between before and after sodium bicarbonate supplementation in terms of Klotho and Hco3 in chronic kidney disease patients stage 3b to 4.
Study of Procalcitonin Level in Obese Prevalent Hemodialysis Patients and Its Relation to Hemodialysis Adequacy
Authors: El-Wakeel Mahmoud Talaat Mahmoud , Saeed Saeed Abdelwahab , Abdelwahab Khaled Gouda , Mohamed Ahmed Yehia 
Published: August 2023

Abstract

Introduction
In hemodialysis (HD) patients procalcitonin considered as an early predictor of acute infection. It represents a new and potential marker of inflammation and may correlate with dialysis adequacy. This makes procalcitonin a potential biomarker for obesity-related low-grade inflammation.

Objective
To assess procalcitonin level in obese prevalent hemodialysis patients and its relation to hemodialysis adequacy

Methods
A cross sectional study was conducted on 90 patients divided into 3 groups, 40 obese (BMI ≥ 30 Kg/m2) ESRD patients on regular hemodialysis at dialysis unit of El-Sahel Teaching Hospital (group A), 40 non obese (BMI &lt; 25 Kg/m2) ESRD patients on regular hemodialysis (group B) and 10 healthy individuals with BMI &lt; 25 Kg/m2 as a control group (group C).All patients were subjected to detailed history taking and general examination. All patients were laboratory investigated for CBC, serum urea, creatinine, CRP, Urea reduction ratio (URR), equilibrated Kt/v. All controls were subjected to written informed consent, full history and examination and CRP level. Procalcitonin level was done by ELISA technique for all patients and control.

Results
In our study, we found that there was a higher level of procalcitonin (PCT) in obese hemodialysis patient than non-obese. We also found that there was no correlation between PCT and hemodialysis adequacy in our study population.

Conclusion
Our study showed that procalcitonin is a potential biomarker for obesity-related low-grade inflammation. But not related to hemodialysis adequacy.
Study of Neutrophil–Lymphocyte Ratio, Interleukin-6 (IL-6) and Tumor Necrosis Factor-Alpha (TNF-α) in Type 2 Diabetes with Diabetic Nephropathy
Authors: Sabry Inas Mohamed , Mahdy Maram Mohamed Maher , Elhalawany Salah Hussien Aly , Ahmed Marwa Mohamed Ali 
Published: August 2023

Abstract

Background
Diabetic kidney disease is defined by characteristic structural and functional changes. The predominant structural changes include mesangial expansion, glomerular basement membrane thickening, podocyte injury, and, ultimately, glomerular sclerosis. The major clinical manifestations of diabetic nephropathy are albuminuria, hematuria (less often), and, in many patients, progressive chronic kidney disease, which can be slowed with optimal therapy.

Objective
to assess the Neutrophil-lymphocyte Ratio, Interleukin- 6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in Type 2 Diabetes with Diabetic Nephropathy.

Patients and Methods
In Our study We collect 90 subjects with their ages ranging from 35-70, selected from Internal Medicine and Endocrinology outpatient clinics and the inpatient department at Ain Shams University Hospitals.

Results
As regards NLR, there were statistically significant and direct correlations between NLR and IL6, TNF, serum BUN, serum creatinine and albumin to creatinine ratio, while significant and indirect correlation with EGFR. As regards IL6, there were statistically significant and direct correlations between IL6 and TNF, serum BUN, serum creatinine and albumin to creatinine ratio, while significant and indirect correlation with BMI and EGFR. As regards TNF, there were statistically significant and direct correlations between TNF and serum BUN and albumin to creatinine ratio. There is no statistical difference between the studied groups as regard sex, age, BMI, SBP, DBP.

Conclusion
The current study could find that NLR, IL-6 and TNF-α were significantly associated with albuminuria in Type 2 Diabetic patients with DN and that they can be used as evident biomarkers in assessing the progression of deteriorating renal function and different stages of renal disease in patients with DN.