nagwa abd el-ghaffar
Cairo University, Clinical Pathology, Department Member
Research Interests: Endocrinology, Cardiology, Medicine, Pregnancy, Internal Medicine, and 15 morePreeclampsia, Atrial Fibrillation, Etiology, Ischemic Stroke, Pediatric Pulmonology, Clinical Sciences, Biomarker, Gestation, Neurosciences, Receiver Operating Characteristic, Brain Natriuretic Peptide, Gestational hypertension, Respiratory distress, glasgow outcome scale, and Paediatrics and reproductive medicine
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ObjectiveThe aim of the study was to determine whether serum neutrophil gelatinase-associated lipocalin (NGAL) can be a possible marker of steroid sensitivity in childhood nephrotic syndrome (NS). Patients and methodsForty patients... more
ObjectiveThe aim of the study was to determine whether serum neutrophil gelatinase-associated lipocalin (NGAL) can be a possible marker of steroid sensitivity in childhood nephrotic syndrome (NS). Patients and methodsForty patients between the ages of 1 and 18 years of both sexes, diagnosed with idiopathic NS, were enrolled in this study, along with 20 age-matched and sex-matched healthy controls. They were attending the Nephrology Clinic, Abu El Rish Hospital, Cairo University. Patients were categorized into the following subgroups: (a) those with steroid-sensitive nephrotic syndrome (n=13); (b) those with steroid-dependence nephrotic syndrome (n=19); and (c) those with steroid-resistant nephrotic syndrome (n=8). The demographic and clinical data were recorded for all participants. A blood sample was taken from each participant to measure serum NGAL (using sandwich enzyme immunoassay). Serum albumin, serum cholesterol, blood urea nitrogen, and serum creatinine were measured using colorimetric techniques. Renal biopsy was performed on 15 patients. ResultsThe mean serum NGAL level was significantly (P<0.001) higher in steroid-resistant nephrotic syndrome (40.2 ng/ml) than in steroid-dependence nephrotic syndrome patients (29.6 ng/ml), steroid-sensitive nephrotic syndrome patients (16.6 ng/ml), and healthy controls (13.6 ng/ml). NGAL levels demonstrated a significant positive correlation with serum creatinine. ConclusionSerum NGAL may be used as a marker for steroid resistance in NS in children. In addition, NGAL levels correlate with the severity of renal impairment, probably expressing the degree of active renal damage.
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Introduction Cardiovascular disease has increased as a complication of chronic kidney disease even in the absence of diabetes or hypertension. Angiopoietin-1 and 2 are 55 kDa antagonistic nonredundant gatekeepers of endothelial activation... more
Introduction Cardiovascular disease has increased as a complication of chronic kidney disease even in the absence of diabetes or hypertension. Angiopoietin-1 and 2 are 55 kDa antagonistic nonredundant gatekeepers of endothelial activation and thus are potential important factors in accelerated atherosclerosis. Aim of the study The aim of the study was to determine angiopoietin-2 level in patients on hemodialysis (stage 5) and in the predialytic stages (stages 3 and 4) and to find the relationship between angiopoietin-2 levels and glomerular filtration rate in the predialytic stages. Patient and methods We prospectively studied 75 patients divided into three groups and 12 healthy controls. Group 1 included 33 patients on maintenance hemodialysis three times a week; group 2 included 21 patients with stage 3 chronic kidney disease; and group 3 included 21 patients with stage 4 chronic kidney disease. Results We found highly significant ( P P r - 0.858, P r - 0.825, P r - 0.438, P r − 0.468, P r − 0.503, P r 0.456, P < 0.05) in group 3. Conclusion Circulating angiopoietin-2 is a putative marker and potential mediator of atherosclerosis, is inversely related to glomerular filtration rate, and is increased with advanced chronic kidney disease. Normolipidemia in chronic kidney disease patients does not prevent atherosclerotic burden; this is because of the presence of other markers such as angiopoietin-2.
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Background: Fetuin-A is a liver-derived plasma protein, mediates the formation and stabilization of calciprotein particles formation, ensures mineral solubilization, thus preventing pathological calcification, also it promotes insulin... more
Background: Fetuin-A is a liver-derived plasma protein, mediates the formation and stabilization of calciprotein particles formation, ensures mineral solubilization, thus preventing pathological calcification, also it promotes insulin resistance. Objective: To study the role of fetuin A as a marker for early diabetic nephropathy in type 2 diabetes mellitus. Subjects and Methods: Cross sectional study including 30 diabetic patients without microalbuminuria (group I), 30 diabetic patients with microalbuminuria (Group II) and age and sex matched 30 healthy subjects served as a control group. All patients and control subjects were thoroughly examined clinically. Fasting and post prandial blood sugar, HbA1c, renal function tests, lipid profile, creatinine clearance, albumin/creatinine ratio and serum fetuin A by ELISA were investigated. Results: Serum Fetuin A increased in diabetic nephropathy patients without microabuminuria compared to those with microabuminuria. Significant negative c...
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ObjectiveThe aim of the study was to investigate the relationship between serum E-selectin (as a marker of endothelial activation) and vascular complications in children and adolescents with type 1 diabetes mellitus (T1DM). Participants... more
ObjectiveThe aim of the study was to investigate the relationship between serum E-selectin (as a marker of endothelial activation) and vascular complications in children and adolescents with type 1 diabetes mellitus (T1DM). Participants and methodsThis was a case–control study including 30 children with T1DM (with mean age 10.8 years, disease duration 7.4 years) and 30 matched healthy controls. Serum E-selectin, glycosylated Hb (HbA1c), total cholesterol, and triglycerides (TG) were determined. Blood pressure and anthropometric parameters were also measured. ResultsLevels of serum E-selectin, cholesterol, and TG in patients were significantly higher than in controls; these levels were also higher in metabolically poorly controlled and albuminuric T1DM patients compared with metabolically well-controlled and nonalbuminuric T1DM patients. There was a positive correlation between serum E-selectin and HbA1c (r=0.9, P<0.001), diastolic blood pressure (DBP) Z-score (r=0.5, P<0.01), cholesterol (r=0.7, P<0.001), TG (r=0.6, P<0.001), and duration of diabetes (r=0.4, P<0.03). After adjustment for age, HbA1C, serum cholesterol, serum TG, BMI Z-score, systolic blood pressure Z-score, DBP Z-score, and duration of diabetes, the strongest significant associations were shown between serum E-selectin and glycosylated Hb (HbA1c). ConclusionWe conclude that elevated biological markers of endothelial cell activation, such as serum E-selectin, may be related to vascular complications of DM, such as diastolic hypertension and microalbuminuria, in children with type 1 diabetes.
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Research Interests: Endocrinology, Humans, Child, Internal Medicine, Female, and 15 moreInfant, Bone Density, Iron, Bone Mineral Density, Bone remodeling, Blood Transfusion, Free Fatty Acid, Beta Thalassemia, Bone Resorption, Chelation Therapy, Case Control Studies, Deferoxamine, Child preschool, Cardiovascular medicine and haematology, and Carnitine
Arterial stiffness was reported with corona virus disease 2019 (COVID-19). We studied atherosclerosis in COVID-19 directly through duplex ultrasound measurements and their relation to co-morbidities, clinical and laboratory severity... more
Arterial stiffness was reported with corona virus disease 2019 (COVID-19). We studied atherosclerosis in COVID-19 directly through duplex ultrasound measurements and their relation to co-morbidities, clinical and laboratory severity markers, and serum interleukin (IL) 6 and 17. Serum IL 6 and 17, average carotid intima-media thickness (cIMT), diameter and peak systolic velocities (PSV) of tibial, ulnar, radial arteries, and ankle brachial index (ABI) were measured in 44 COVID-19 patients and 44 healthy controls. Serum IL6, IL17, PSV, and cIMT were higher while diameter was lower ( P ≤ .01) in cases. Clinical severity index correlated positively with age, co-morbidities, ferritin, IL6, IL17, cIMT, and PSV ( P ≤ .04) and negatively with diameter and ABI ( P = .04). Patients with severe lymphopenia had higher PSV, IL6, and IL17 and lower diameter ( P < .00001). Ferritin positively correlated with PSV and negatively with diameter and ABI ( P ≤ .01). Those who received an IL6 inhibito...
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I read the interesting study by Fawzy et al. [1] published in the September–December 2018 issue of the The Scientific Journal of Al Azhar Medical Faculty, Girls. The authors assessed bone mineral density (BMD) and determined its... more
I read the interesting study by Fawzy et al. [1] published in the September–December 2018 issue of the The Scientific Journal of Al Azhar Medical Faculty, Girls. The authors assessed bone mineral density (BMD) and determined its relationship with serum irisin and other hormonal parameters in women with polycystic ovary syndrome (PCOS) [1]. They found that serum irisin level, fasting insulin, and homeostatic model assessment of insulin resistance were significantly higher in the PCOS group compared with the control group. They also found that serum irisin level, waist circumference, and fasting serum insulin were the predictors for the z-score of the spine in the PCOS group. They concluded that serum irisin level might be considered as a novel biomarker for PCOS diagnosis and that circulating irisin was strongly related to the BMD and bone metabolism [1]. I presume that the following methodological limitation might cast some suspicions on the accuracy of the study results. In the methodology, the authors mentioned that the determination of BMD on lumber spine and left femur was done using dual-energy radiography absorptiometry scan employing MEDIX DR dualenergy radiography absorptiometry scan [1]. However, they did not address which BMD reference values (BMDRVs) were employed to interpret BMD readings. It is explicit that BMDRVs are controlled by various determinants, namely, age, sex, weight, ethnicity, pubertal stage, and socioeconomic standard [2,3]. Accordingly, normative BMDRVs have been constructed for certain female populations to be employed in the researches and clinical field [4]. Egypt is a pioneer in constructing BMDRVs for women population as having a national standard gives a better idea of the BMD status than using a foreign population reference standard. [5]. I wonder why the authors did not refer to the national BMDRVs in their study. I presume that employing them could better delineate BMD profile and its correlation with various hormonal parameters in the Egyptian women with PCOS.
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Thalassemia is a congenital hemolytic disease caused by defective globin synthesis treated by blood transfusion. Transfusion-transmitted infections still make a great challenge in the management of patients with thalassemia major. The... more
Thalassemia is a congenital hemolytic disease caused by defective globin synthesis treated by blood transfusion. Transfusion-transmitted infections still make a great challenge in the management of patients with thalassemia major. The most important worldwide transfusion-transmitted infections are hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV. The objective of this study is to update the prevalence of the three major transfusion-transmitted infections HCV, HBV and HIV among thalassemic patients followed up in the Hematology Department, Children Hospital, Cairo University. The study included 174 multitransfused thalassemic patients (162 major and 12 intermedia), registered at the Pediatric Hematology Clinic, Cairo University. Their age ranged from 2 to 27 years with a mean of 11.26 ± 5.4 years. Patients were subjected to full history taking, stressing on history of blood transfusions (onset, frequency and duration) at a single or multiple centers and abdominal examination. Laboratory investigations including complete blood count, aminotransferases (aspartate aminotransferase and alanine aminotransferase), ferritin and viral markers of HBV surface antigen (HBsAg), HCV antibodies (anti-HCV) and anti-HIV were assayed for all cases by a third-generation ELISA method. HCV PCR was performed for 75 cases. Of the 174 patients, none of them were HBsAg and anti-HIV positive. However, 90 patients were anti-HCV positive (51.7%). HCV PCR was positive in 56 patients (74.3%) of the 75 with positive antibody tested. HCV antibody positivity is statistically significant with age of the patient, serum ferritin and liver transaminases (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). HCV-RNA by PCR positivity was significantly related to patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; age and serum ferritin (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Serum ferritin showed statistically significant positive correlation with liver transaminases. Despite the decrease in prevalence of HCV antibody in our patients from 71% in 1995 to 51.7% in our study, yet HCV infection still represents a major health problem for our thalassemic patients, which requires more attention and efforts to challenge. There is a dramatic decrease in the prevalence of HBV infection over the last decade, thanks to mass compulsory vaccination and blood screening. HIV infection does not represent a problem owing to very low population prevalence.
Research Interests: Hematology, Gastroenterology, Egypt, Adolescent, Hepatitis C, and 15 moreHIV, Antibodies, Hepatitis B, Child, Hepatitis C Virus, Blood Coagulation, Clinical Sciences, Adult, Blood Transfusion, Hepatitis B virus, Enzyme Linked Immunosorbent Assay, HBsAg, Child preschool, Hepacivirus, and HIV infections
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3 Abstract: The most important reason for risk increase in diabetic patients is endothelial dysfunction and subclinical low grade systemic inflammation. Ischemia modified albumin (IMA) is produced as a result of serum albumin flowing... more
3 Abstract: The most important reason for risk increase in diabetic patients is endothelial dysfunction and subclinical low grade systemic inflammation. Ischemia modified albumin (IMA) is produced as a result of serum albumin flowing through ischemic tissues and is a marker of oxidative stress and ischemia, as serum level of modified albumin rise in many diseases accompanied by ischemia. In this study we evaluated the relationship between serum IMA and lipid profile in type 2 Egyptian diabetic patients. Forty subjects participated in this study; 20 of them were type 2 diabetic patients with normal lipid profile; 20 patients were type 2 diabetic patients with dyslipidemia; and 10 subjects as a control group. The study revealed a significant positive correlation of serum IMA to glycosylated hemoglobin of type 2 diabetic patients without dyslipidemia and a non significant correlation of serum IMA to all lipids of the patients of the same group. The study also revealed a significant pos...
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BACKGROUND Interleukin 37 (IL-37) is an anti-inflammatory cytokine previously studied in Behçet's disease (BD) and atherosclerosis. However, little is known about its relation to macro and microcirculations in BD. Previous studies... more
BACKGROUND Interleukin 37 (IL-37) is an anti-inflammatory cytokine previously studied in Behçet's disease (BD) and atherosclerosis. However, little is known about its relation to macro and microcirculations in BD. Previous studies relied mainly on common carotid artery (CCA) intima-media thickness (IMT) and ankle brachial index (ABI) to study atherosclerosis in BD with conflicting results. This study evaluated flow parameters of CCA, ABI and nailfold videocapillaroscopy in relation to serum IL-37 in BD. METHODS Forty BD patients and 30 healthy controls were included. IMT, peak-systolic, end-diastolic velocities, resistivity index of CCA and ABI were measured by duplex ultrasound. Capillary loop, length, diameter and morphology were recorded by nailfold videocapillaroscopy. Serum IL-37 levels were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS Compared to controls, patients had higher mean CCA IMT (p< 0.0001), resistivity index (p<0.001) and peak-systolic velocity (p=0.09) and lower mean CCA end-diastolic velocity (p=0.002), capillary loop, length, arterial, venous limbs diameter and serum IL-37 (p<0.001). Patients with ABI ≥ 1.4 "indicating stiff arteries" had higher serum IL-37 (p<0.05 on left, p>0.05 right sides). Serum IL-37 correlated negatively with left CCA end-diastolic velocity "denoting atherosclerosis" and positively with left posterior tibial artery ABI and CRP (p<0.03) "denoting inflammation". Multiple regression analysis showed only association with left CCA end-diastolic velocity. CONCLUSIONS IL-37 may be related to arterial stiffness in BD and could be used as a marker in further investigations. Changes of CCA peak-systolic, end-diastolic velocities, resistivity index and IMT refer to increased atherosclerosis in larger elastic arteries. In smaller muscular "crural" arteries, vasculitis with possible medial disease may be more evident.
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Background Great prevalence of patients with type 2 diabetes mellitus (T2DM) has been witnessed in the last decades worldwide. The global prevalence has been estimated to reach 6.4% among adults at the beginning of the current decade.... more
Background Great prevalence of patients with type 2 diabetes mellitus (T2DM) has been witnessed in the last decades worldwide. The global prevalence has been estimated to reach 6.4% among adults at the beginning of the current decade. Diabetic nephropathy is considered the most common complication that affects the kidney and plays as a leading cause of end-stage kidney disease. The presence of proteinuria in diabetic patients is a sign of risk. Vitamin D is a multitrait steroid hormone involved in a wide spectrum of cell regulatory and metabolic functions. Multiple diseases were observed to be frequently associated with low levels of vitamin D. Objective To estimate the level of vitamin D in T2DM patients, to assess its relation to microalbuminuria, and to estimate the effect of vitamin D replacement on these patients. Patients and methods A case–control study was conducted on 50 T2DM patients having microalbuminuria (group 1), 50 T2DM patients with no microalbuminuria (group 2), and 50 apparently healthy persons (group 3) (the control group), Routine tests such as complete blood count, fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin’, liver enzyme tests [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], kidney function tests (urea, creatinine), lipid profiles [cholesterol, Triglyceride (TG)], serum albumin, calcium, phosphorus, intact parathyroid hormone (PTH), 25-hydroxycholecalciferol in the blood, and urinary albumin/creatinine ratio were done. Results The study showed highly statistically significant decrease of vitamin D level in group 1 (diabetes with microalbuminuria) compared with group 2 (diabetes without microalbuminuria) and group 3 (control) (P<0.001). A statistically significant negative correlation was found between microalbuminuria and vitamin D (r=−0.946). It also showed a highly statistically significant decrease of microalbuminuria after treatment with vitamin D compared with before treatment .There was a highly statistically significant decrease of glycosylated hemoglobin after vitamin D replacement. Conclusion This study demonstrated that vitamin D was significantly deficient in diabetic patients in comparison with the control group and it is significantly deficient in T2DM with microalbuminuria compared with T2DM without microalbuminuria. It showed that microalbuminuria was significantly improved after treatment with vitamin D but not to nonmicroalbminuric level. These findings indicated that there is a potential role of vitamin D in diabetic nephropathy pathogenesis.
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Abstract: Allergen immunotherapy is the administration of gradually increasing quantities of an allergen vaccine to an allergic subject, reaching a dose which is effective in ameliorating the symptoms associated with subsequent exposure... more
Abstract: Allergen immunotherapy is the administration of gradually increasing quantities of an allergen vaccine to an allergic subject, reaching a dose which is effective in ameliorating the symptoms associated with subsequent exposure to the causative allergen. So allergy vaccine immunotherapy is a treatment that can modify allergic disease. In the present study we evaluated a period of one and half year of house dust mite immunotherapy on the concentrations of two immunologic markers: Eosinophil cationic protein (ECR) and nitric oxide (NO). We also compared the effect on asthma symptoms, allergen specific bronchial challenge test and the skin prick test. The immunotherapy was performed on 36 mite allergic, asthmatic children (age range from 6-15 years) were included in our study. Twenty of the cases were treated with sublingual immunotherapy (55.5%) and 17 cases were controls as they refused to receive the medication. Efficacy was evaluated clinically on asthma symptoms and by me...
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Background Chronic inflammation and airway remodeling have important roles in asthma pathophysiology. Transforming growth factor β1 (TGF-β1) and YKL-40 play a very important role in the pathogenesis of asthma. Aim The aim of this work was... more
Background Chronic inflammation and airway remodeling have important roles in asthma pathophysiology. Transforming growth factor β1 (TGF-β1) and YKL-40 play a very important role in the pathogenesis of asthma. Aim The aim of this work was to find noninvasive biomarkers that may enable us to assess asthma severity as a surrogate for invasive bronchial mucosa biopsy. Therefore, we studied the correlation between TGF-β1 and YKL-40 and asthma severity. Patients and method The work was done on 40 patients with asthma who were classified into two groups: 20 patients with mild asthma and 20 patients with severe but stable asthma. A third group of 20 normal participants was taken as control. Immunoglobulin E total, YKL-40, and TGF-β1 were determined in serum of all studied groups. Results The results showed highly significant increased serum TGF-β1 and serum YKL-40 in patients with asthma compared with control group, and they were positively correlated with disease severity. Conclusion We c...
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Introduction: Aldosterone is a potent mineralocorticoid. It plays a key role in mediating adverse myocardial remodeling with pressure overload. The aims of this study were to compare the serum levels of aldosterone in well controlled and... more
Introduction: Aldosterone is a potent mineralocorticoid. It plays a key role in mediating adverse myocardial remodeling with pressure overload. The aims of this study were to compare the serum levels of aldosterone in well controlled and uncontrolled cases of long standing essential hypertension and correlate these levels to the echocardiographic findings of these patients. Material and methods: Eighty subjects were enrolled in the study: 30 well controlled hypertensives, 30 uncontrolled hypertensives and 20 subjects matched for age and sex as a control group. Results: There was a significant elevation of serum aldosterone level in hypertensive patients which was especially marked in uncontrolled hypertensives compared to the control group. There was a significant positive correlation between aldosterone level and hypertension duration, mean systolic and mean diastolic blood pressure. There was a significant positive correlation between aldosterone level and posterior wall thickness...
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Retinol-binding protein-4 (RBP4), a novel adipokine secreted mainly by visceral adipose tissue, increased serum levels has been associated with obesity, type 2 diabetes and metabolic syndrome. The aim of our study is to detect the... more
Retinol-binding protein-4 (RBP4), a novel adipokine secreted mainly by visceral adipose tissue, increased serum levels has been associated with obesity, type 2 diabetes and metabolic syndrome. The aim of our study is to detect the relation between various parameters of insulin resistance and serum RBP4 in type 2 Egyptian diabetic obese patients (T2DM). In a case control study 60 obese type 2 diabetic patients (40 females/20 males) with mean BMI (34.63±4.22 Kg/m 2 ) compared to 15 healthy controls subjects, age and sex matched. Laboratory and anthropometric measurements including: fasting blood glucose, HbA1C, lipid profile, urea, creatinine, RBP4 serum levels, BMI, and waist/hip ratio. Our results demonstrated statistically significant elevation in serum RBP4 concentrations in T2DM subjects compared to control subjects (P<0.001). Significant correlations were observed between the serum RBP4 concentration and fasting blood glucose(r=0.237, P=0.005). In obese diabetic there was neg...
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Allergen immunotherapy is the administration of gradually increasing quantities of an allergen vaccine to an allergic subject, reaching a dose which is effective in ameliorating the symptoms associated with subsequent exposure to the... more
Allergen immunotherapy is the administration of gradually increasing quantities of an allergen vaccine to an allergic subject, reaching a dose which is effective in ameliorating the symptoms associated with subsequent exposure to the causative allergen. So allergy vaccine immunotherapy is a treatment that can modify allergic disease. In the present study we evaluated a period of one and half year of house dust mite immunotherapy on the concentrations of two immunologic markers: Eosinophil cationic protein (ECR) and nitric oxide (NO). We also compared the effect on asthma symptoms, allergen specific bronchial challenge test and the skin prick test. The immunotherapy was performed on 36 mite allergic, asthmatic children (age range from 6-15 years) were included in our study. Twenty of the cases were treated with sublingual immunotherapy (55.5%) and 17 cases were controls as they refused to receive the medication. Efficacy was evaluated clinically on asthma symptoms and by measuring th...
Background: Vitamin D deficiency is a common problem in the world. Leading to osteopenia, osteoporosis, and bone fracture. Objective: we amid to measure serum vitamin D level in healthy Egyptian individuals. Subjects and Methods: Ninety... more
Background: Vitamin D deficiency is a common problem in the world. Leading to osteopenia, osteoporosis, and bone fracture. Objective: we amid to measure serum vitamin D level in healthy Egyptian individuals. Subjects and Methods: Ninety healthy individuals with 45 males (50%) with age ranged 20-59 with mean (35.69 ± 10.64) and 45 females (50%) with age ranged 18-58 years with mean (38.20±11.80) participant in this study, all participants allocated from outpatient clinic for routine checkup of internal medicine department of Al-Zahraa University Hospital of Al-Azhar University and Al-Haram Hospital, Cairo, Egypt. Results: 27 (30.0%), 39 (43.3%) 24 (28.7%) had deficient, insufficient and sufficient vitamin D (vit D), respectively. There was a highly significant reduction in mean (20.05 ± 5.80) of vit D25 in peoples wholly covered by clothes (wear niqab) when compared to mean (25.78 ± 7.71) of vit D25 in peoples not wholly covered by clothes (not wear niqab) (p<0.01). There was a hi...
Introduction Spontaneous bacterial peritonitis (SBP) is a potentially fatal condition, characterized by infection of ascitic fluid (AF) in the absence of any intra-abdominal surgically treatable source of infection. It is the most... more
Introduction Spontaneous bacterial peritonitis (SBP) is a potentially fatal condition, characterized by infection of ascitic fluid (AF) in the absence of any intra-abdominal surgically treatable source of infection. It is the most frequent and severe complication of cirrhotic ascites. SBP is a condition that requires a high index of suspicion, rapid and accurate diagnosis, in addition to prompt and effective therapy. Aim The aim of this study was to evaluate AF calprotectin as a diagnostic marker in detecting SBP. In addition, we have evaluated AF calprotectin-to-albumin ratio in the diagnosis and prognosis of SBP. Patients and methods A total of 72 patients with cirrhotic ascites were included in this study. They were divided into two groups: SBP group included 50 patients with cirrhotic ascites and SBP diagnosed by presence of polymorphonuclear leukocyte count at least 250 cells/mm3 in AF with or without positive AF culture, and non-SBP group included 22 patients with cirrhotic ascites without evidence of SBP. All patients were subjected to complete clinical evaluation, laboratory investigations, diagnostic abdominal paracentesis, serum and AF C-reactive protein levels, which were assessed quantitatively, and AF calprotectin levels, which were measured by quantitative sandwich enzyme-linked immunosorbent assay. Results AF calprotectin was significantly elevated in patients with SBP in comparison with non-SBP patients (P<0.001), with the best cutoff value for the detection of SBP (372 ng/ml) with a sensitivity, specificity, positive predictive value, negative predictive value, and an accuracy of 100% for each. Moreover, there was a positive correlation with total leukocytic count, polymorphonuclear leukocyte, and C-reactive protein in serum and AF. Moreover, calprotectin-to-albumin ratio was increased in SBP group versus non-SBP group (P<0.001). Conclusion AF calprotectin can be used as a valuable marker in rapid diagnosis of SBP. Moreover, calprotectin-to-albumin ratio in ascites is useful in the diagnosis of SBP, as well as it provides prognostic information on short-term survival of patients with SBP with follow-up treatment.
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Systemic Lupus Erythematosus (SLE) is a chronic and potentially fatal autoimmune disorder characterized by the production of auto-antibodies that cause widespread tissue damage. Validate Antichromatin antibodies as a biomarker of renal... more
Systemic Lupus Erythematosus (SLE) is a chronic and potentially fatal autoimmune disorder characterized by the production of auto-antibodies that cause widespread tissue damage. Validate Antichromatin antibodies as a biomarker of renal involvement in SLE and how their titers correlate with systemic lupus activity measure (SLAM) index among a sample of Egyptian systemic lupus patients. The study was conducted on 60 patients diagnosed according to ACR criteria for diagnoses of SLE (Group I) and 25 age matched healthy controls (Group II). Group I was divided into 30 patients without nephritis group A 1 and 30 patients with nephritis group IB. (anti-dsDNA, Antinuclear antibodies ANA), rheumatoid factor (RF), Complement component C3, C4 and antichromatin antibodies were done for all patients and controls. Serum antichromatin antibodies were positive in all cases of SLE and negative in all control subjects and were higher in group1B than group IA also; there were significant positive corr...
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Objective Pre-eclampsia is accompanied by both maternal and neonatal complications. Histidine-rich glycoprotein (HRG) is a protein interacting with angiogenesis, coagulation, and inflammatory reactions, which are involved in the... more
Objective Pre-eclampsia is accompanied by both maternal and neonatal complications. Histidine-rich glycoprotein (HRG) is a protein interacting with angiogenesis, coagulation, and inflammatory reactions, which are involved in the development of pre-eclampsia. We assessed the value of combining early second trimester maternal serum HRG and uterine artery Doppler in predicting pre-eclampsia. Patients and methods A total of 140 pregnant women were divided into two groups: group A (n=70), a high-risk group, and group B (n=70), a control group. They were subjected to measurement of maternal serum HRG at 16–18 weeks of gestation and uterine artery Doppler assessment at 20–22 weeks of gestation. All pregnancies were followed up until delivery for development of pre-eclampsia. Results The cases that developed pre-eclampsia had lower serum levels of HRG and higher pulsatility index. Our cutoff value for serum HRG to predict pre-eclampsia was less than 40.6 µg/ml and the cutoff value for mean pulsatility index was less than 1.24. The sensitivity, specificity, positive predictive value, negative predictive value, and total accuracy of uterine artery Doppler combined with serum HRG for pre-eclampsia prediction were 71.4, 97.1, 96.1, 77.3, and 84.3%, respectively. Conclusion This combination test may be a useful early second trimester screening test for the prediction of pre-eclampsia.
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ObjectiveThe aim of this study was to identify the etiology, risk factors, and the most common clinical features of newly diagnosed diabetes in children and adolescents, in addition to the factors related to delayed diagnosis or... more
ObjectiveThe aim of this study was to identify the etiology, risk factors, and the most common clinical features of newly diagnosed diabetes in children and adolescents, in addition to the factors related to delayed diagnosis or mismanagement in these children. Materials and methodsNinety-nine children and adolescents aged from one month to 13 years with newly diagnosed type 1 diabetes (T1DM) were recruited from the inpatient department of the Diabetic, Endocrine, and Metabolic Pediatric Unit (DEMPU), New Children Hospital, Cairo University. ResultsClassic symptoms (polyuria and polydipsia, and weight loss) were the most common symptoms (the first two symptoms in 95.9 and the last one in 90.7%) preceding the diagnosis, and diabetic ketoacidosis was present in 51.5% of cases. Delayed and missed diagnosis was recorded in 49.5% of patients, with no significant relation with age, district of accommodation, or family history of diabetes. Cow’s milk feeding was more frequent, being recorded in 75.2% vs. 19.6% with exclusive breast feeding, and positive family history of diabetes was recorded in 77.3%. Severity at presentation showed no significant relation with age, type of feeding, family history of diabetes, or C-peptide level. ConclusionIncreased public awareness of early symptoms of diabetes is needed to reduce the frequency and severity of ketoacidosis. In addition, greater medical alertness to the possibility of T1DM in a young child should be stressed. Breastfeeding and avoidance of early cow milk introduction should be encouraged to decrease the risk for T1DM during infancy with its early complications and morbidity.
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BACKGROUND: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of hematopoietic stem cells. It is characterized at the cytogenetic level by Philadelphia (ph) chromosome and at the molecular level by the BCR/ABL gene... more
BACKGROUND: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of hematopoietic stem cells. It is characterized at the cytogenetic level by Philadelphia (ph) chromosome and at the molecular level by the BCR/ABL gene rearrangement. Bone marrow derived mesenchymal stem cells (MSCs) are pluripotent stem cells that can differentiate into several mesenchymal tissues.AIM: To observe the biological characteristics of MSCS from CML patients and to determine whether MSCs harbor the abnormal BCR/ABL translocation similar to CML bone marrow cells.SUBJECTS AND METHODS: Characterized MSCs were isolated from 12 newly diagnosed Philadelphia positive untreated CML patients.RESULTS: MSCs can be readily isolated from CML marrow and exhibit major expansion. Flow cytometry analysis revealed the typical MSC phenotype. Moreover; MSCs do not harbor the BCR/ABL translocation confirmed by karyotype and real time PCR.CONCLUSION: MSCs from CML patients express the typical MSC phenotype; an...
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BACKGROUND: Hepatitis C virus is one of the most common etiologic agents of chronic liver diseases, including liver cirrhosis and hepatocellular carcinoma in which there is continuous inflammation and regeneration of... more
BACKGROUND: Hepatitis C virus is one of the most common etiologic agents of chronic liver diseases, including liver cirrhosis and hepatocellular carcinoma in which there is continuous inflammation and regeneration of hepatocytes.Cytokeratin-18 (CK18) has been suggested to play an important role in tumorigenesis of epithelial cancers.AIM: Estimation of CK18 serum levels in patients with chronic viral hepatitis C (CHCV) and hepatocellular carcinoma (HCC) and find the relationship between their levels, the severity of the disease and the development of HCC.METHODS: We measured serum levels of CK18 in 60 Egyptian patients (30 with CHCV & 30 with HCC) and 30 healthy controls.RESULTS: Patients with HCC had highly significant increased CK18 levels compared with CHCV patients, healthy controls. Cytokeratin-18 among the three classes of Child-Pugh classification show highly significant gradual increase from child A to C. Furthermore, In HCC there were positive correlations between CK18 and w...
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Very few biomarkers exist for monitoring chron- ic kidney disease (CKD). We have recently shown that serum neutrophil gelatinase-associated lipocalin (NGAL) represents a novel biomarker for early identification of acute kidney injury. In... more
Very few biomarkers exist for monitoring chron- ic kidney disease (CKD). We have recently shown that serum neutrophil gelatinase-associated lipocalin (NGAL) represents a novel biomarker for early identification of acute kidney injury. In this study, we hypothesized that serum ...