bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Serum Markers of Iron Metabolism in Pediatric Patients with Chronic Liver Disease
Authors: El Qabany Zainab Anwar , Abdelaziz Asmaa Wafeeq , Ragab Dina Ali , Hassan Senosy Eman Ali 
Published: August 2023

Introduction
The liver is a critical controller of iron metabolism as it represents a large iron storage compartment and a major producer of ferritin, transferrin and hepcidin (Pietrangelo, 2015 & Meynard et al., 2014). Disorders in the metabolism of iron in the direction of iron overload are observed not only in primary hemochromatosis but also in chronic liver diseases with other eitiologies. (Ibrahim, 2013).

Objectives
-To describe the parameters of iron metabolism in pediatric patients with chronic liver disease.
-To correlate serum parameters of iron metabolism and severity of chronic liver disease.

Methods
An analytical case-control study was performed in Ain Shams University Pediatric Hospital, we conducted 40 pediatric patients presented to the hepatology clinic and 20 control children collected by convenience sample, cases and controls were age and gender matched. The severity of the diseases was assessed by Child’s-Pugh Classification score (Patients were 15 % class A, 42.5% class B and 42.5 % class C) and iron profile assessment was done by separated plasma analyzed in AU480 Chemistry Analyzer Beckman Coulter, correlation between iron profile parameters and severity of liver disease was done.

Results
- Iron overload was significant in cases over controls presented by increase serum iron in cases (Mean 116.53 SD ± 18.35) over controls (Mean 70.3 ± SD 18.82)(p &lt; 0.001), increase serum ferritin levels in cases (Mean 138.38 SD ± 17.82) over controls (87.55 ± 22.76) (p &lt; 0.001), increase transferrin saturation in cases (Mean 41.88 SD ± 10.85) over controls (Mean 17.83 ± SD 6.01) (p &lt; 0.001), and decrease total iron binding capacity in cases (Mean 291.33 ± SD 51.87) lower than controls (Mean 405.05 ± SD 46.13) (p &lt; 0.001). -- There was a positive significant correlation between S iron 0.773(p &lt; 0.001), S ferritin 0.367(p &lt; 0.001), Transferrin Sat. 0.788(p &lt; 0.001) and progression in Child'sPugh classification score. And a negative significant correlation between TIBC -0.736(p &lt; 0.001) and progression in Child’s-Pugh classification score.

Conclusion
- Iron overload correlates with increase chronic liver disease severity (assessed by Child’s-Pugh Classification).
-The serum parameters of iron (S iron, S ferritin, Transferrin Sat and TIBC) may serve as biomarkers for monitoring the increase in severity of liver disease in pediatrics with chronic liver disease.
The Predictive Value of Serum IL-6 in Pediatric Critically Ill Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19
Authors: Ibrahim Hanan M , Mansour Mervat GE , Rezk Ahmed R , Ahmed Hossam K 
Published: August 2023

Background
Unexplained cases of fatal rapidly spreading viral pneumonia were reported in December 2019 in Wuhan, China. A novel type of coronavirus, SARS-COV-2, was isolated during the examination of patients' samples. By May 2019, the novel coronavirus has been responsible for more than 3 million infections worldwide with a case fatality rate up to 7%.

Aim of the Work
To evaluate the correlation between serum level of IL-6 and cases of COVID-19 and Multisystem inflammatory syndrome in children (MIS-C) progression and outcome.

Patients and Methods
This is a cohort study that was conducted at the Pediatric Intensive Care Unut, Ain Shams University. It included 53 patients whose median age was 6 years and ranged between 2-10 years. They were divided into 24 patients (45%) with COVID and 29 patients with MIS-C (55%). Laboratory work up done to both groups include : routine laboratory tests (CBC, CRP, ESR, serum ferritin) and measurement of serum IL-6 using ELISA (Normal values up to 7pg/ml).

Results
Median serum level of IL-6 was higher albeit insignificant in patients with MIS-C as compared to those with COVID (Median:72.7 pg/ml (range: 20.2-140.5 pg/ml) versus a median of 53 pg/ml (range:17.2-293.2) respectively. Serum IL 6 was significantly positively correlated with CRP, ESR and ferritin in both MIS-C and COVID patients groups (p &lt; 0.05). Among MIS-C patients, the best cut off point of serum IL6 to predict severe course and mortality was &gt;168.2 pg/ml, while among COVID patients, the best cut off level was slightly lower &gt;146 pg/ml.

Conclusion
Systemic inflammation is a feature of COVID and MIS-C in part reflected by increased serum IL 6 and increased ESR, CRP and Ferritin. Increased serum IL 6 has excellent sensitivity to severe MIS-C and COVID with good specificity. It's low predictive value for mortality suggest it's limited value to predict the outcome in severe cases as indicated by the multiple factors interacting in the disease course.
The Role of Chitinase-3-Like Protein 1(YKL-40) as a Biomarker of Psoriatic Arthritis
Authors: Mohammed Rana S , Sebaie Mona A El , Awad Mohamed A , Salama Sherihan M 
Published: August 2023

Background
Psoriatic arthritis (PsA) is a chronic multifaceted inflammatory seronegative arthritis. Plasma YKL-40 is an inflammatory biomarker.

Objective
To evaluate the role of Chitinase-3-like protein 1 (YKL-40) as a diagnostic biomarker in psoriatic arthritis (PsA) patients and determine its value in assessment of disease activity and severity in PsA patients.

Patients and Methods
This study included twenty five adult patients with clinical evidence of PsA and twenty five healthy matched age and sex as control group. All underwent history, laboratory investigation, clinical examination, assessment of disease activity using Disease Activity in PSoriatic Arthritis (DAPSA) Score and assessment of severity of PsA using Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Leeds Enthesitis Index (LEI) and examination of dactylitis.

Results
The mean age of patients was 39.72 ± 11.94. Also, The mean age of healthy controls was 42.88 ± 12.11. There was highly statistically significant difference regarding the serum levels of YKL- 40 (P &lt; 0.01) between the patients and the control groups (P &lt; 0.01). The receiver operating characteristic curve (ROC) curve of YKL -40 showed that the sensitivity and the specificity of YKL- 40 in diagnosis of PsA were 96% and 92% respectively. There were statistically significant positive correlations between YKL- 40 levels (μl/mL) and each of PASI score (p = 0.005) (r = 0.539) and DAPSA score (p = 0.007) (r = 0.526).

Conclusion
YKL- 40 measurement may serve as a diagnostic biomarker for PsA, as it has the potential to contribute to the fundamental processes underlying the pathogenesis of PsA. So, the results of this study suggested that the addition of YKL- 40 as a serological marker has a valuable role in diagnosis of PsA and reflection of disease activity.
The Role of Transcranial Grayscale and Doppler Ultrasound Examination in Diagnosis of Neonatal Hypoxic-Ischemic Encephalopathy
Authors: Aly Zeinab A , Hemeda Yasmin H , Al-Ghannam Adel M 
Published: August 2023

Objectives
To evaluate role of transcranial grayscale ultrasound (TC-GSUS) and transcranial color Doppler (TCD) in diagnosis of neonatal Hypoxic-ischemic encephalopathy (HIE).

Materials & Methods
26 neonates with suspected HIE underwent sonographic examinations using SonoScape SSI-6000 ultrasound device that is equipped by L743 linear array probe with frequency 5-10 MHz. TC-GSUS was performed at levels of anterior, mastoid and posterior fontanelles and at level of temporal window. TCD was performed using Color-coded Doppler study of the intracerebral vessels to assess brain perfusion and detect ischemic brain changes. Resistance index (RI) was considered abnormal in preterm neonates if it was &lt;0.54 or &gt; 0.86 and if it was &lt;0.52 or &gt; 0.8 for term neonates.

Results
According to cranial biometry, TC-GSUS has negative and positive rates for HIE of 7.7% and 92.3%, respectively. Using TC-GSUS periventricular leukomalacia, intraventricular hemorrhage, brain edema and hydrocephalus were detected in 17, 19, 14 and 16 patients, respectively. According to RI of intracranial vessels, TCD excluded HIE in 11 patients and assured diagnosis of HIE in 15 patients. TC-GSUS can diagnose HIE in neonates with sensitivity, specificity and accuracy rates of 87.5%, 30% and 65.4%, respectively. ROC curve analysis defined abnormally high RI of intracranial arteries as the significant specific predictor for the presence of NHIE and as the significant sensitive predictor for HIE severity grade. Regression analysis defined high RI of internal carotid artery (ICA) as the most specific predictor for presence of HIE, while high RI of anterior cerebral artery (ACA) was the most sensitive predictor for high grade HIE.

Conclusion
TCD can diagnose HIE in neonates with high sensitivity and specificity and abnormal RI of ICA and ACA could be used as accurate diagnostic tests. Whenever, TCD was unavailable, TC-GSUS could diagnose HIE with accuracy rate of 65.4% versus TCD.
Recent Advances of TIRADS Classification of Thyroid Nodules by Ultrasound
Authors: Ibrahim Ayman Mohammed , Shokry Wessam Sherin , Ebrahim Hanan Ebrahim Mousa 
Published: August 2023

Background
Thyroid nodules are abnormal growths of thyroid tissue which commonly arise within an otherwise normal thyroid gland. They may be hyperplasia or a thyroid neoplasm, but only a small percentage of the latter are thyroid cancers. Small, asymptomatic nodules are common, and many people who have them are unaware of them. Thyroid nodules can be felt as a lump in the throat. When they are large, they can sometimes be seen as a lump in the front of the neck.

Objectives
The aim of this work was to improve the management of the patients and to reduce cost-effectiveness by decreasing number of unnecessary fine needle aspiration cytology (FNAC).

Patients and Methods
This study was conducted on 50 patients with thyroid nodules detected by clinical palpation or incidentally noted during neck imaging for other reasons. There were 33females (74%) and 17 males (26%). Their ages ranged from 41 to 50 years. All patients in the study were subjected to full history taking, thorough clinical examination. Gray scale Ultrasound and color Doppler examination were done to all patients. The nodules were classified into TIRADS categories and the risk of malignancy was calculated for each category.

Results
All the nodules with TIRADS 1 were benign. In TIRADS 2 there were 10 benign and 1 malignant nodules. In TIRADS 3 there were 4 benign and 1 malignant nodules. In TIRADS 4 there were 2 benign nodules and 4 benign nodules while in TIRADS 5 there were 2 benign and 4 malignant nodules. There was a statistically significant difference between the two groups. There was a statistically significant difference between the two groups with benign and malignant nodules regarding the texture of the nodules. Solid texture was higher in the malignant nodules and spongiform texture was common in the benign nodules while the cystic and mixed texture were comparable between the two groups. Hypoechoic nodules were higher in the malignant nodules, however, there was no statistically significant difference between the two groups with benign and malignant nodules regarding the echogenicity of the nodules. There was a statistically significant difference between the two groups with benign and malignant nodules regarding the echogenic foci.

Conclusion
The major ultrasound features seen associated with malignancy were microcalcifications, taller than wider shape of the nodule, hypoechoic and marked hypoechoic echopattern of the nodule, irregular borders and presence of suspicious cervical lymph nodes.
Role of MRCP in Patients with Jaundice When Biliary Tree Is Normal on Previous Imaging
Authors: Younan Kirolos Monir Barsoum , El Gaafary Sahar Mohamed , Madkour sherihan Said 
Published: August 2023

Background
Obstructive jaundice is one of the most frequent and grave form of hepatobiliary disease. It is important for treatment planning to detect level and cause of obstruction.

Aim of the Work
To assess the role of MRCP in patients presented with jaundice, right hypochondrial pain with the absence of dilated biliary system by ultrasound.

Patients and Methods
This was cross sectional study that included 38 patients who presented with obstructive jaundice or right hypochondrial pain with normal biliary system by ultrasound referred to the Radio diagnosis Department for MRCP.

Results
MRCP has high sensitivity reaching 100% and high specificity reaching 93.33% in gall bladder pathology and high specificity 100% in biliary and pancreatic pathology in comparison to ultrasound.

Conclusion
if there is high clinical suspicion of ductal pathology when patient presented by jaundice or right hypochondrial pain with abnormal liver function tests despite normal biliary tree by ultrasound, an MRCP examination should be strongly considered as next imaging modality of choice
Bronchial Artery Einbolization for Treatment of Hemoptysis from Cavitary Lung Lesions
Authors: Mohamed Ahmed Mostafa , El Din Nourhan Mohammed Hossam , Abdelaziz Norhan Abozeid Ahmed , ElShimy Ahmed 
Published: August 2023

Background
Treatment for liemoptysis is not limited to surgery, and among the various options, bronchial artery emboli/anon is regarded as an effective approach.

Aim of the Work
To evaluate the technique, efficacy, and safety of Bronchial Artery Embolization in patients with haemoptysis from cavitary lung lesions.

Patients and Methods
Our study was a reconstructive (retrospective and prospective) cohort study that was held during the period between March 2021 and September 2021. The study included 20 patients who presented with hacmoptysis due to cavitary lung lesions refractory to supportive treatment measures. Patients were referred from chest department to interventional Radiology Unit, Ain Shams University Hospitals.

Results
Massive hemoptysis was seen in 15 patients and recurrent mild-moderate in 5 patients. On imaging cavitary lesions were seen at left side in 8 patients, right side in 8 patients, and bilateral involvement in 4 patients. Bronchiectatic changes were the predominant pathology seen in 6 patients, immediate success was achieved in 20 patients, while recurrence within one month was noted at 4 patients. Minor complications such as chest pain were recorded in 13 patients yet no major complications such as spinal cord ischemic.

Conclusion
BAE is a safe and effective procedure with a negligible complication rate that can be performed routinely in patients presenting with heimoptysis,
Evaluation of the Relationship between Carotid Intima Media Thickness and Coronary Artery Disease in Patients Evaluated by CT Coronary Angiography
Authors: Ibrahim Ahmed Samir , Hassan Hend Galal Eldeen Mohamed Ali , Azziz Mohamed Samar Essam Abdul 
Published: August 2023

Background
Coronary artery disease (CAD) is associated with high mortality around the world, hypertension, diabetes and smoking are common risk factors for CAD.

Aim of the Work
Our study aims to explore the relationship between CIMT and coronary artery disease (CAD) in patients evaluated by coronary angiography for suspected CAD.

Patients and Methods
This cross-sectional study was carried out in radiology department, Faculty of medicine, Ain Shams University. All patients gave their written informed consent for taking part in this study. The study was approved by Ethical Committee of Faculty of medicine, Ain Shams University. It included 30 patients that were referred for MDCTA for coronary arteries study and IMT measuring by ultrasonography, Patients were referred for coronary CTA because of known or suspected coronary artery disease (CAD).

Results
We conducted our study on 30 patients 80% were males and 20 % were females aged between 30-70 years by using ECG gated 128 MDCT then ultrasonography examination for CIMT evaluation, Patients were referred for coronary CTA because of known or suspected CAD. 60% of cases were smokers, 66.7% of cases had hypertension, 73.3% had DM and 63.3 % had hyperlipidemia. Both imaging modalities showed overall good agreement and the concordance was better for moderate and higher grades of atherosclerosis than for low grade.

Conclusion
Higher values of CIMT were found in patients with various coronary risk factors (DM, Hypertension and hyperlipidemia). Carotid duplex ultrasonography provides a simple, easy and non-invasive tool for detection of CAD. It can be used as a predictor for incidence of CAD. There was also a significant relation between CIMT and the extent of CAD, noted as increased number of coronary vessels affected. Finally we demonstrated the usefulness of carotid intima media thickness in predicting coronary artery disease.
Risk Factors and Predictors of Occlusion of Stent of Trans Jugular Intrahepatic Porto-Systemic Shunt (TIPSS) in Egyptian Patients with Primary Budd Chiari Syndrome: A Single Center Experience
Authors: El-Din Fatma Ahmed Ali , Elmaaty Mohamed El-Ghareeb Abo , Atteya Heba Rashad , Ibrahim Ibrahim Abd El-Hakim 
Published: August 2023

Background
Budd–Chiari syndrome is a heterogeneous group of disorders characterized by hepatic venous outflow obstruction at the level of the hepatic venules, the large hepatic veins, the inferior vena cava till its junction with the right atrium. The classic triad of abdominal pain, ascites, and hepatomegaly is observed in the vast majority of patients with Budd-Chiari syndrome. The diagnosis of BCS is made by clinical presentation and confirmatory investigations. Standard laboratory investigations are rarely helpful in establishing the diagnosis, because abnormal liver function tests are not specific for BCS, real time Gray-scale sonography combined with colour flow is considered by some to be the initial imaging technique. The recommended stepwise therapeutic algorithm of BCS is mainly by medical treatment with anticoagulation, angioplasty with or without stenting, TIPS of surgical shunting and liver transplantation if indicated. TIPS is a common teqnique used in BCS and TIPS stent occlusion is major complication.

Objectives
To identify the possible risk factors and predictors of stent occlusion in primary BCS patients who underwent TIPSS.

Patients and Methods
The studied patients were selected from patients presented to Budd Chiari outpatient clinic. Tropical medicine department in Ain Shams University hospitals. total number of cases during the study period was 76 cases fulfilling the inclusion criteria, they were divided in 2 groups according to patency of TIPS stent and comparing both groups regarding their pre and post TIPS data.

Results
The mean age of the patients was (29.29 ± 7.92) with female predominance. FVLM (69.7%) & MTHFRD (67.1%) were the most common causes of BCS in the studied patients. positive and higher CRP results were found in the occluded stent patients than patent groups. also, higher TLC levels were found in the occluded TIPS stent patients.

Conclusion
Identifying these risk factors may help predict the outcome of TIPS stent patency.
Comparison between Levels of Vitamin D in Primary Mono-Symptomatic Nocturnal Enuresis and Non-Enuretic Children
Authors: Sayed Shaker Hasan , Abdelfattah Dyaa' Eddin , Badr Abdallah Mohamed Said Rashad 
Published: August 2023

Background
Enuresis (synonymous with intermittent nocturnal incontinence) refers to discrete episodes of urinary incontinence during sleep in children 25 years of age. Enuresis can be divided into primary enuresis (PE) and secondary enuresis (SE). A child who has never been dry is considered to have PE; a child who has been continent for at least 6 months before the onset of the bedwetting is considered to have SE. The pathogenesis of PE is similar to that of SE.

Aim of the Study
To compare between the levels of Vitamin D - as an important factor in growth and development - in primary monosymptomatic enuretic and non-enuretic children.

Patients and Methods
This is a case control study was performed in Ain Shams University Hospitals, Damanhour National Medical Institute. The study started on February 2020. The study included 60 children with primary mono-symptomatic nocturnal enuresis selected randomly and 60 healthy children age and sex matched children as a control group.

Results
We found that 61.7% of cases in the NE group had low Vit.D level (&lt;20ng/ml) compared with 40% in the control group and this difference is statistically significant

Conclusion
Our study indicates that there • is a significant relationship between primary monosymptomatic nocturnal enuresis and serum vitamin D deficiency.
Stone Heterogeneity Index as a New Parameter for Prediction of Shockwave Lithotripsy Outcomes
Authors: Aggour Abd El Fattah Mohammed , El Shawaf Hisham , Omar Kareem , Nasef Abd El RahmanHossam Mahmoud 
Published: August 2023

Background
Renal stones are a major public health concern with continuously increasing prevalence. Extracorporeal shock wave lithotripsy (ESWL) which was introduced more than three decades ago as an authentic modality for the treatment of urinary stone disease is considered first choice of treatment for nearly all kind of urinary tract calculi. The outcome of ESWL for renal and ureteral stones depends on many factors, including stone size, Hounsfield Unit (HU), Skin Stone Distance (SSD) and Body Mass Index (BMI).

Objective
To introduce the concept of Stone Heterogeneity Index (SHI) as a single factor or in combination with other factors that predict the outcome of extracorporeal shock wave lithotripsy for adult patients with renal or ureteral stones.

Methods
This is a prospective study conducted on 60 Patients with renal and ureteral stones planned to have ESWL sessions attending urology outpatient clinic in Ain shams university and Misr University for Science and Technology hospitals.

Results
The radiologic heterogeneity of a urinary stone or SHI was independently associated with SWL success in patients with renal and ureteral calculi. SHI in the success group was 246.49 ± 82.13 while in the failure group was 159.20 ± 47.59 with Cutoff point &lt; 183 predicting failure of ESWL outcome. SHI between success and failure groups was statistically significant being higher in success group. (p = 0.000).

Conclusion
SHI will play a promising role when determining a treatment modality in patients with a urinary stone, and especially when selecting the proper SWL candidates from the patients with a stone of large size or high Mean Stone Density (MSD).