Pub Date : 2023-11-03DOI: 10.1186/s43162-023-00260-x
Josef Finsterer
{"title":"Re-infections with SARS-CoV-2 require a clarification of favourable risk factors","authors":"Josef Finsterer","doi":"10.1186/s43162-023-00260-x","DOIUrl":"https://doi.org/10.1186/s43162-023-00260-x","url":null,"abstract":"","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135820380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-19DOI: 10.1186/s43162-023-00257-6
Kwame Yeboah, Francys Frimpong Otu, Jennifer Adjepong Agyekum, Bartholomew Dzudzor
Abstract Background Brain-derived neurotrophic factor (BDNF) has been implicated in the development of cardiometabolic risk factors in some populations. However, few studies have investigated the role of BDNF and cardiometabolic risk factors in HIV patients despite the plethora of evidence linking HIV infection with the dysregulation of circulating BDNF levels. We investigated the association between serum BDNF and cardiometabolic risk factors in HIV patients in a primary hospital in Ghana. We recruited 450 participants, comprising 150 combination antiretroviral (cART)-treated HIV patients, 150 cART-naïve HIV patients, and 150 non-HIV controls. Data on sociodemographic parameters and medical history were collected using a structured questionnaire. Fasting venous blood samples were collected to measure plasma glucose levels, lipid profiles, and BDNF. Metabolic syndrome (MetS) was defined using the joint interim statement criteria. Results Compared to untreated HIV patients and uninfected controls, the proportion of participants having MetS was high in cART-exposed HIV patients (26.8% vs 21.1% vs 52.1%, respectively, p < 0.001). Generally, BDNF levels were higher in uninfected controls compared with untreated and cART-exposed HIV patients [7.1 (3.4–13.3) vs 4.9 (2.7–9.6) vs 5.6 (2.9–8.9) ng/ml, p = 0.025]. In participants without MetS, square root-transformed serum BDNF was lowest in cART-exposed HIV patients, followed by untreated HIV patients, with uninfected controls having the highest (1.8 ± 0.8 vs 2.4 ± 1.2 vs 2.9 ± 1.2 ng/ml, p < 0.001). MetS was associated with serum BDNF levels in only the cART-exposed HIV patients [OR (95% CI) = 2.98 (1.64–5.41), p < 0.001]. In cART-exposed HIV patients, an increase in BDNF was associated with increased likelihood of having impaired fasting glucose [2.49 (1.51–4.11), p < 0.001], high systolic blood pressure [1.64 (1.1–2.46), p = 0.016], and hypertriglyceridemia [2.73 (1.65–4.52), p < 0.001], as well as decreased likelihood of having low HDL cholesterol levels [0.32 (0.19–0.56), p < 0.001]. Conclusion In our study population, MetS was higher in cART-exposed HIV patients. HIV patients have low levels of serum BDNF, especially those without MetS. BDNF was associated with MetS and its components in HIV patients on cART management.
脑源性神经营养因子(BDNF)在一些人群中与心脏代谢危险因素的发展有关。然而，尽管有大量证据表明HIV感染与循环BDNF水平失调有关，但很少有研究调查了BDNF和HIV患者心脏代谢危险因素的作用。我们调查了加纳一家初级医院HIV患者血清BDNF与心脏代谢危险因素之间的关系。我们招募了450名参与者，包括150名联合抗逆转录病毒(cART)治疗的HIV患者，150名cART-naïve HIV患者和150名非HIV对照组。使用结构化问卷收集社会人口学参数和病史数据。采集空腹静脉血样本，测量血糖水平、血脂和BDNF。代谢综合征(MetS)的定义采用联合中期声明标准。结果与未经治疗的HIV患者和未感染的对照组相比，cart暴露的HIV患者发生met的比例较高(分别为26.8% vs 21.1% vs 52.1%)， p <0.001)。一般来说，与未经治疗和cart暴露的HIV患者相比，未感染对照组的BDNF水平更高[7.1 (3.4-13.3)vs 4.9 (2.7-9.6) vs 5.6 (2.9-8.9) ng/ml, p = 0.025]。在没有MetS的参与者中，cart暴露的HIV患者的平方根转化血清BDNF最低，其次是未经治疗的HIV患者，未感染的对照组最高(1.8±0.8 vs 2.4±1.2 vs 2.9±1.2 ng/ml, p <0.001)。met仅在cart暴露的HIV患者中与血清BDNF水平相关[OR (95% CI) = 2.98 (1.64-5.41)， p <0.001]。在cart暴露的HIV患者中，BDNF的增加与空腹血糖受损的可能性增加相关[2.49 (1.51-4.11)，p <0.001]、高收缩压[1.64 (1.1-2.46)，p = 0.016]、高甘油三酯血症[2.73 (1.65-4.52)，p <0.001]，以及降低高密度脂蛋白胆固醇水平的可能性[0.32 (0.19-0.56)，p <0.001]。结论在我们的研究人群中，cart暴露的HIV患者met较高。HIV患者血清BDNF水平较低，特别是那些没有met的患者。在接受cART治疗的HIV患者中，BDNF与met及其成分相关。
{"title":"Brain-derived neurotrophic factor is associated with cardiometabolic risk factors in HIV patients on combination antiretroviral therapy in Ghana","authors":"Kwame Yeboah, Francys Frimpong Otu, Jennifer Adjepong Agyekum, Bartholomew Dzudzor","doi":"10.1186/s43162-023-00257-6","DOIUrl":"https://doi.org/10.1186/s43162-023-00257-6","url":null,"abstract":"Abstract Background Brain-derived neurotrophic factor (BDNF) has been implicated in the development of cardiometabolic risk factors in some populations. However, few studies have investigated the role of BDNF and cardiometabolic risk factors in HIV patients despite the plethora of evidence linking HIV infection with the dysregulation of circulating BDNF levels. We investigated the association between serum BDNF and cardiometabolic risk factors in HIV patients in a primary hospital in Ghana. We recruited 450 participants, comprising 150 combination antiretroviral (cART)-treated HIV patients, 150 cART-naïve HIV patients, and 150 non-HIV controls. Data on sociodemographic parameters and medical history were collected using a structured questionnaire. Fasting venous blood samples were collected to measure plasma glucose levels, lipid profiles, and BDNF. Metabolic syndrome (MetS) was defined using the joint interim statement criteria. Results Compared to untreated HIV patients and uninfected controls, the proportion of participants having MetS was high in cART-exposed HIV patients (26.8% vs 21.1% vs 52.1%, respectively, p < 0.001). Generally, BDNF levels were higher in uninfected controls compared with untreated and cART-exposed HIV patients [7.1 (3.4–13.3) vs 4.9 (2.7–9.6) vs 5.6 (2.9–8.9) ng/ml, p = 0.025]. In participants without MetS, square root-transformed serum BDNF was lowest in cART-exposed HIV patients, followed by untreated HIV patients, with uninfected controls having the highest (1.8 ± 0.8 vs 2.4 ± 1.2 vs 2.9 ± 1.2 ng/ml, p < 0.001). MetS was associated with serum BDNF levels in only the cART-exposed HIV patients [OR (95% CI) = 2.98 (1.64–5.41), p < 0.001]. In cART-exposed HIV patients, an increase in BDNF was associated with increased likelihood of having impaired fasting glucose [2.49 (1.51–4.11), p < 0.001], high systolic blood pressure [1.64 (1.1–2.46), p = 0.016], and hypertriglyceridemia [2.73 (1.65–4.52), p < 0.001], as well as decreased likelihood of having low HDL cholesterol levels [0.32 (0.19–0.56), p < 0.001]. Conclusion In our study population, MetS was higher in cART-exposed HIV patients. HIV patients have low levels of serum BDNF, especially those without MetS. BDNF was associated with MetS and its components in HIV patients on cART management.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135778672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-17DOI: 10.1186/s43162-023-00226-z
Shaimaa Elkholy, Kareem Essam, Gina Gamal, Karim K. Maurice, Zeinab Abdellatif, Mohammed El-Sherbiny, Hany Haggag, Abeer Awad, Kerolis Yousef
Abstract Background and study aims Peroral endoscopic myotomy (POEM) has been regarded as a novel and minimally invasive therapy for the treatment of achalasia. Data from the Middle East and North Africa (MENA) region and Arabic countries are scarce, and this study represents the first study from this area. The aim of this study was to assess the efficacy and safety of POEM in an Egyptian cohort. Patients and methods This is a prospective study that included 34 Egyptian patients who underwent POEM for achalasia. Results This study included 19 (55.9%) males with a median age of 33.5 years (range: 11–75 years). 16 (47.1%) patients had previous pneumatic balloon dilation, and 1 (2.9%) patient had previous surgical myotomy. The median Eckardt score pre-POEM was 9 (range: 4–12). The median integrated relaxation pressure for 4 s (IRP4s) was 25.6 mmHg (range: 11.5–49.4 mmHg). High-resolution manometry showed that 12 patients had type I achalasia (35.2%), 18 patients had type II achalasia (52.9%), and 4 patients had type III achalasia (11.7%). The median procedure time was 120 min (range: 75–260 min). Technical success was achieved in all patients (100%), and clinical success was achieved in 33/34 patients (97.1%). There was no significant difference in success rates among different types of achalasia (p 0.208). There was a significant reduction in the Eckardt score ( P < 0.0001) and IRP4s values pre- and post-POEM ( P < 0.0001). There was also a significant increase in the body mass index of the patients (P 0.006) during a median follow-up of 10 months (range: 6–24 months). Conclusions POEM is a safe, effective, and feasible treatment option for achalasia in an Egyptian cohort. POEM is becoming an attractive option and is gaining patient satisfaction.
{"title":"Peroral Endoscopic Myotomy (POEM) for the treatment of achalasia in an Egyptian cohort","authors":"Shaimaa Elkholy, Kareem Essam, Gina Gamal, Karim K. Maurice, Zeinab Abdellatif, Mohammed El-Sherbiny, Hany Haggag, Abeer Awad, Kerolis Yousef","doi":"10.1186/s43162-023-00226-z","DOIUrl":"https://doi.org/10.1186/s43162-023-00226-z","url":null,"abstract":"Abstract Background and study aims Peroral endoscopic myotomy (POEM) has been regarded as a novel and minimally invasive therapy for the treatment of achalasia. Data from the Middle East and North Africa (MENA) region and Arabic countries are scarce, and this study represents the first study from this area. The aim of this study was to assess the efficacy and safety of POEM in an Egyptian cohort. Patients and methods This is a prospective study that included 34 Egyptian patients who underwent POEM for achalasia. Results This study included 19 (55.9%) males with a median age of 33.5 years (range: 11–75 years). 16 (47.1%) patients had previous pneumatic balloon dilation, and 1 (2.9%) patient had previous surgical myotomy. The median Eckardt score pre-POEM was 9 (range: 4–12). The median integrated relaxation pressure for 4 s (IRP4s) was 25.6 mmHg (range: 11.5–49.4 mmHg). High-resolution manometry showed that 12 patients had type I achalasia (35.2%), 18 patients had type II achalasia (52.9%), and 4 patients had type III achalasia (11.7%). The median procedure time was 120 min (range: 75–260 min). Technical success was achieved in all patients (100%), and clinical success was achieved in 33/34 patients (97.1%). There was no significant difference in success rates among different types of achalasia (p 0.208). There was a significant reduction in the Eckardt score ( P < 0.0001) and IRP4s values pre- and post-POEM ( P < 0.0001). There was also a significant increase in the body mass index of the patients (P 0.006) during a median follow-up of 10 months (range: 6–24 months). Conclusions POEM is a safe, effective, and feasible treatment option for achalasia in an Egyptian cohort. POEM is becoming an attractive option and is gaining patient satisfaction.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136032626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-17DOI: 10.1186/s43162-023-00256-7
Shafat Iqbal Bhati, S. F. Haque, S. S. Siddiqi, Rizwan Ahmad
Abstract Diabetes mellitus is a common metabolic disorder characterized by chronic hyperglycemia and disturbance of carbohydrate, fats, and protein metabolism. Type 2 diabetes mellitus results from reduced insulin secretion, decreased glucose utilization, and increased glucose production, which results in hyperglycemia. Hypertension further increases the risk of cardiovascular diseases, including coronary heart disease (CHD), congestive heart failure (CHF), ischemic and hemorrhagic stroke, renal failure, and peripheral arterial disease (PAD). Angiotensin receptor blockers (ARBs) are very effective antihypertensive drugs. This study was done to find the effects of two different angiotensin receptor blockers on various biochemical markers in type-2 diabetes mellitus patients. Methods This was a prospective interventional study, comparing two ARBs Azilsartan and telmisartan, involving 76 patients with type 2 diabetes mellitus and hypertension. Results Both drugs controlled blood pressure equally. The study showed that improvement in fasting plasma glucose was more with Azilsartan as compared to Telmisartan but their mean difference is not statistically significant ( p > 0.05). The improvement in post-prandial plasma glucose and HbA1C was more with Telmisartan as compared to Azilsartan but only mean HbA1C was statistically significant ( p < 0.05). Conclusions Telmisartan has a better impact on HbA1c reduction than Azilsartan, as a part of the pleotropic effect of ARBs.
{"title":"Effects of two different angiotensin receptor blockers on blood glucose level and HbA1c in type-2 diabetes mellitus patients with hypertension","authors":"Shafat Iqbal Bhati, S. F. Haque, S. S. Siddiqi, Rizwan Ahmad","doi":"10.1186/s43162-023-00256-7","DOIUrl":"https://doi.org/10.1186/s43162-023-00256-7","url":null,"abstract":"Abstract Diabetes mellitus is a common metabolic disorder characterized by chronic hyperglycemia and disturbance of carbohydrate, fats, and protein metabolism. Type 2 diabetes mellitus results from reduced insulin secretion, decreased glucose utilization, and increased glucose production, which results in hyperglycemia. Hypertension further increases the risk of cardiovascular diseases, including coronary heart disease (CHD), congestive heart failure (CHF), ischemic and hemorrhagic stroke, renal failure, and peripheral arterial disease (PAD). Angiotensin receptor blockers (ARBs) are very effective antihypertensive drugs. This study was done to find the effects of two different angiotensin receptor blockers on various biochemical markers in type-2 diabetes mellitus patients. Methods This was a prospective interventional study, comparing two ARBs Azilsartan and telmisartan, involving 76 patients with type 2 diabetes mellitus and hypertension. Results Both drugs controlled blood pressure equally. The study showed that improvement in fasting plasma glucose was more with Azilsartan as compared to Telmisartan but their mean difference is not statistically significant ( p > 0.05). The improvement in post-prandial plasma glucose and HbA1C was more with Telmisartan as compared to Azilsartan but only mean HbA1C was statistically significant ( p < 0.05). Conclusions Telmisartan has a better impact on HbA1c reduction than Azilsartan, as a part of the pleotropic effect of ARBs.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136032896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Background Chronic liver disease and decompensated cirrhosis are associated with serious complications; spontaneous bacterial peritonitis is considered one of them that may lead to sepsis and adrenal insufficiency. This trial aimed to study the role of dehydroepiandrosterone sulfate (DHEAS) and DHEAS/cortisol ratio for assessing cirrhotic patients’ adrenal function and as a possible prognostic factor in cirrhotic cases with spontaneous bacterial peritonitis (SBP). Patients and methods It was a prospective cohort trial carried out on 100 patients in the Internal Medicine Department, Tanta University Hospital, from June 2021 to July 2022 divided into 2 studied patient groups: group I, 50 cases with liver cirrhosis and sterile ascites; and group II, 50 cases with liver cirrhosis and SBP. Adrenal function was evaluated using serum cortisol levels (9 A.M, 9 P.M, and post synacthen stimulation test), DHEAS level, and DHEAS/cortisol ratio. Results The cirrhotic patients with SBP have significantly decreased DHEAS, decreased DHEAS/cortisol ratio, and high cortisol level post stimulation compared with patients with sterile ascites, cirrhotic cases with decreased DHEAS/cortisol ratio (< 0.65) had elevated C-reactive protein (CRP) levels, a higher model for end-stage liver disease (MELD) score and Child–Pugh score had higher hospital mortality. Both DHEAS and the DHEAS/cortisol ratio were significant predictors of hospital mortality (area under the receiver operating characteristic curve 0.267 and 0.298, respectively). The cirrhotic patients with SBP had decreased DHEAS and DHEAS/cortisol ratio but higher hospital mortality, compared to the cirrhotic patients with sterile ascites. Conclusions It was found that a significant increase in cortisol level was after synacthen stimulation, decreased DHEAS, and low DHEAS to cortisol ratio in the cirrhotic patients with spontaneous bacterial peritonitis and was associated with high mortality compared to cirrhotic patients without spontaneous bacterial peritonitis.
{"title":"Dehydroepiandrosterone sulfate to cortisol ratio as a prognostic factor in cirrhotic patients with spontaneous bacterial peritonitis","authors":"Mohamed Ramadan Asker, Loai Mohamed Elahwal, Sahar Mohy-Eldin Hazzaa, Shireen Ali Elhoseeny, Mohamed Elsayed Sarhan","doi":"10.1186/s43162-023-00258-5","DOIUrl":"https://doi.org/10.1186/s43162-023-00258-5","url":null,"abstract":"Abstract Background Chronic liver disease and decompensated cirrhosis are associated with serious complications; spontaneous bacterial peritonitis is considered one of them that may lead to sepsis and adrenal insufficiency. This trial aimed to study the role of dehydroepiandrosterone sulfate (DHEAS) and DHEAS/cortisol ratio for assessing cirrhotic patients’ adrenal function and as a possible prognostic factor in cirrhotic cases with spontaneous bacterial peritonitis (SBP). Patients and methods It was a prospective cohort trial carried out on 100 patients in the Internal Medicine Department, Tanta University Hospital, from June 2021 to July 2022 divided into 2 studied patient groups: group I, 50 cases with liver cirrhosis and sterile ascites; and group II, 50 cases with liver cirrhosis and SBP. Adrenal function was evaluated using serum cortisol levels (9 A.M, 9 P.M, and post synacthen stimulation test), DHEAS level, and DHEAS/cortisol ratio. Results The cirrhotic patients with SBP have significantly decreased DHEAS, decreased DHEAS/cortisol ratio, and high cortisol level post stimulation compared with patients with sterile ascites, cirrhotic cases with decreased DHEAS/cortisol ratio (< 0.65) had elevated C-reactive protein (CRP) levels, a higher model for end-stage liver disease (MELD) score and Child–Pugh score had higher hospital mortality. Both DHEAS and the DHEAS/cortisol ratio were significant predictors of hospital mortality (area under the receiver operating characteristic curve 0.267 and 0.298, respectively). The cirrhotic patients with SBP had decreased DHEAS and DHEAS/cortisol ratio but higher hospital mortality, compared to the cirrhotic patients with sterile ascites. Conclusions It was found that a significant increase in cortisol level was after synacthen stimulation, decreased DHEAS, and low DHEAS to cortisol ratio in the cirrhotic patients with spontaneous bacterial peritonitis and was associated with high mortality compared to cirrhotic patients without spontaneous bacterial peritonitis.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"1140 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-05DOI: 10.1186/s43162-023-00253-w
Mohamed Osman Omar Jeele, Ahmed Abdirahman Hussein, Mohamed Abdullahi Mohamud, Abdulkamil Abdullahi Adani, Mohamed Farah Yusuf Mohamud
Abstract Introduction Heart failure is one of the major global health problems that we face today, worldwide. The main objective of our study is to evaluate the spectrum and prevalence of renal dysfunction among heart failure patients in Mogadishu, Somalia. The design of the study is a retrospective descriptive study aimed at heart failure patients who presented to the largest tertiary care center in southern somalia between January 2021 to september 2021. Demographic data, co-morbidities, types of heart failure, causes of heart failure and the presence or absence of renal dysfunction were analysed. Results Overall 180 heart failure patients were enrolled in the study. The mean age of the participants was 62.26 ± 14 years. Regarding the age group, patients aged between 61–80 years was the most abundant participants with ( n = 87, 48.3%). Regarding the type of heart failure in our study, HFpEF was the most common type in our respondents with frequency of ( n = 85, 47.2%). When analysed the cause of heart failure among patients; hypertension was the most common cause of heart failure ( n = 90, 50%). Also, hypertension was the most common co-morbidity among our patients ( n = 106, 59%), followed by coronary artery diseases ( n = 50, 28%). The prevalence of renal dysfunction in heart failure patients was ( n = 37, 20.6%). Our analysis showed that among the 37 renal dysfunction patients, 12.3% of them ( n = 22) were CKD (chronic kidney disease) while the remaining 8.3% ( n = 15) had AKI (acute kidney injury). We found a significant correlation between gender and renal dysfunction in heart failure patients with (95% CI: 0.098–0.574, OR: 0.237, p value: < 0.001). Males were 2 and half times more likely to develop renal failure than females. Conclusions we found that the prevalence of renal dysfunction in heart failure patients is 20.6%. It was more prevalent in males and elderly population.
{"title":"Spectrum and prevalence of renal dysfunction among heart failure patients attending tertiary care hospital: first report from Somalia","authors":"Mohamed Osman Omar Jeele, Ahmed Abdirahman Hussein, Mohamed Abdullahi Mohamud, Abdulkamil Abdullahi Adani, Mohamed Farah Yusuf Mohamud","doi":"10.1186/s43162-023-00253-w","DOIUrl":"https://doi.org/10.1186/s43162-023-00253-w","url":null,"abstract":"Abstract Introduction Heart failure is one of the major global health problems that we face today, worldwide. The main objective of our study is to evaluate the spectrum and prevalence of renal dysfunction among heart failure patients in Mogadishu, Somalia. The design of the study is a retrospective descriptive study aimed at heart failure patients who presented to the largest tertiary care center in southern somalia between January 2021 to september 2021. Demographic data, co-morbidities, types of heart failure, causes of heart failure and the presence or absence of renal dysfunction were analysed. Results Overall 180 heart failure patients were enrolled in the study. The mean age of the participants was 62.26 ± 14 years. Regarding the age group, patients aged between 61–80 years was the most abundant participants with ( n = 87, 48.3%). Regarding the type of heart failure in our study, HFpEF was the most common type in our respondents with frequency of ( n = 85, 47.2%). When analysed the cause of heart failure among patients; hypertension was the most common cause of heart failure ( n = 90, 50%). Also, hypertension was the most common co-morbidity among our patients ( n = 106, 59%), followed by coronary artery diseases ( n = 50, 28%). The prevalence of renal dysfunction in heart failure patients was ( n = 37, 20.6%). Our analysis showed that among the 37 renal dysfunction patients, 12.3% of them ( n = 22) were CKD (chronic kidney disease) while the remaining 8.3% ( n = 15) had AKI (acute kidney injury). We found a significant correlation between gender and renal dysfunction in heart failure patients with (95% CI: 0.098–0.574, OR: 0.237, p value: < 0.001). Males were 2 and half times more likely to develop renal failure than females. Conclusions we found that the prevalence of renal dysfunction in heart failure patients is 20.6%. It was more prevalent in males and elderly population.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134975993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-03DOI: 10.1186/s43162-023-00254-9
Hamdy Ibrahim, Safwat Abdel Maksod, Magdy Khorshed, Hanan Rady, Ahmed Alsisi, Adel Mohamed, Nasser Fouad, Ayman Hamed, Mohamed Hosny, Alaaa Al Amir
Abstract Aspergillosis is a common fungus that lives in soil and decaying vegetation. Inhalation of the spores causes infection mostly in immunocompromised patients. Invasive aspergillosis has an extremely high mortality, and a definitive diagnosis requires histopathological evidence of deep tissue invasion or positive culture; however, this evidence is often difficult to obtain due to the critical nature of the patients in these situations. The sensitivity of culture in this setting is also low. The galactomannan test is a recent antigen–antibody serologic test that depends on detecting an antigen which is a molecule found in the cell wall of aspergillus species. A positive result supports the diagnosis of invasive aspergillosis. We present a case of multiple intracerebral brain abscesses in an immunosuppressed patient due to an aspergillus species diagnosed by the galactomannan test with an excellent response to the treatment with the novel voriconazole alone, without any surgical intervention, and the purpose is to alert the physicians, neurologists, and infectious disease specialists to consider the intracranial aspergillosis among the differential diagnosis of the acute onset encephalitis especially in immunocompromised patients as early diagnosis and treatment may be life-saving.
{"title":"Successful treatment of multiple intracerebral aspergillosis with voriconazole alone in an Egyptian diabetic patient with autoimmune hemolytic anemia","authors":"Hamdy Ibrahim, Safwat Abdel Maksod, Magdy Khorshed, Hanan Rady, Ahmed Alsisi, Adel Mohamed, Nasser Fouad, Ayman Hamed, Mohamed Hosny, Alaaa Al Amir","doi":"10.1186/s43162-023-00254-9","DOIUrl":"https://doi.org/10.1186/s43162-023-00254-9","url":null,"abstract":"Abstract Aspergillosis is a common fungus that lives in soil and decaying vegetation. Inhalation of the spores causes infection mostly in immunocompromised patients. Invasive aspergillosis has an extremely high mortality, and a definitive diagnosis requires histopathological evidence of deep tissue invasion or positive culture; however, this evidence is often difficult to obtain due to the critical nature of the patients in these situations. The sensitivity of culture in this setting is also low. The galactomannan test is a recent antigen–antibody serologic test that depends on detecting an antigen which is a molecule found in the cell wall of aspergillus species. A positive result supports the diagnosis of invasive aspergillosis. We present a case of multiple intracerebral brain abscesses in an immunosuppressed patient due to an aspergillus species diagnosed by the galactomannan test with an excellent response to the treatment with the novel voriconazole alone, without any surgical intervention, and the purpose is to alert the physicians, neurologists, and infectious disease specialists to consider the intracranial aspergillosis among the differential diagnosis of the acute onset encephalitis especially in immunocompromised patients as early diagnosis and treatment may be life-saving.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135695640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-02DOI: 10.1186/s43162-023-00255-8
Ahmad AlShomar, Idris Sula, Waleed Al Abdulmonem, Nazmus Saquib
Abstract Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency, an X-linked disorder that is more common in males, is the most prevalent blood enzyme deficiency, affecting 5% of the population worldwide. Its prevalence in Saudi Arabia varies greatly from one region to another (4.7% to 12%), and no related data are available for the country’s Al-Qassim region. Methods This was a retrospective medical record-based study. Eligible patients were those who visited Dr. Sulaiman Al-Habib Hospital in Al-Qassim, Saudi Arabia, between June 2021 and November 2022, and underwent the test for G6PD enzyme deficiency. The study sample consisted of ( n = 313) randomly selected Saudi patients. G6PD enzyme activity was evaluated using spectrophotometry. Results The prevalence of G6PD deficiency was 2.9%. The proportion of male patients (100%) was significantly higher than that of female patients. 88.9% of patients with G6PD deficiency experienced episodes of acute hemolysis and reported a history of favism, whereas 77.8% of the patients had a family history of favism. Conclusion The prevalence of G6PD deficiency was low in Al-Qassim region of Saudi Arabia.
{"title":"Evaluation of the prevalence of glucose-6-phosphate dehydrogenase deficiency in Al-Qassim region of Saudi Arabia","authors":"Ahmad AlShomar, Idris Sula, Waleed Al Abdulmonem, Nazmus Saquib","doi":"10.1186/s43162-023-00255-8","DOIUrl":"https://doi.org/10.1186/s43162-023-00255-8","url":null,"abstract":"Abstract Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency, an X-linked disorder that is more common in males, is the most prevalent blood enzyme deficiency, affecting 5% of the population worldwide. Its prevalence in Saudi Arabia varies greatly from one region to another (4.7% to 12%), and no related data are available for the country’s Al-Qassim region. Methods This was a retrospective medical record-based study. Eligible patients were those who visited Dr. Sulaiman Al-Habib Hospital in Al-Qassim, Saudi Arabia, between June 2021 and November 2022, and underwent the test for G6PD enzyme deficiency. The study sample consisted of ( n = 313) randomly selected Saudi patients. G6PD enzyme activity was evaluated using spectrophotometry. Results The prevalence of G6PD deficiency was 2.9%. The proportion of male patients (100%) was significantly higher than that of female patients. 88.9% of patients with G6PD deficiency experienced episodes of acute hemolysis and reported a history of favism, whereas 77.8% of the patients had a family history of favism. Conclusion The prevalence of G6PD deficiency was low in Al-Qassim region of Saudi Arabia.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"262 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135895651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-27DOI: 10.1186/s43162-023-00252-x
Ahmed Azzam, Heba Khaled
Abstract Background Post-COVID-19 survivors may experience long-term symptoms known as Post-acute COVID-19 syndrome (PACS). The PCAS symptom spectrum includes a wide range of symptoms affecting different organs. The prevalence and risk factors of PACS may vary across different regions, and a meta-analysis focused on Egypt can help understand the national prevalence and unique population-specific predictors. Methods A comprehensive literature search was conducted following the PRISMA guidelines to identify studies published in Egypt that documented symptoms, signs, and post-COVID-19 outcomes in patient cohorts. The results were reported, based on the random effects model, as proportions (%) and odds ratios with 95% CI. Results A total of 16 studies with 3097 COVID-19 survivors and an age range of 3 to 94 years were included in the analysis. The pooled prevalence of COVID-19 survivors experiencing at least one persistent symptom, regardless of hospitalization status, was high at 78.3%. A total of 54 clinical symptoms or conditions were reported among the survivors. The most commonly reported symptom was fatigue, which affected approximately half of all survivors (48.1%). Bone ache or myalgia, anorexia, anxiety, dyspnea, and depression were also among the most frequently reported symptoms at 32.9%, 32.8, 31.5, 19.9, and 19.5, respectively. The pooled prevalence of Post-COVID-19 pulmonary fibrosis (PCPF) among hospitalized Covid survivors was 40%. The study found that female sex, severe COVID, and the presence of any comorbidity were independent risk factors for PACS ( P < 0.05). Conclusion This meta-analysis of 16 studies conducted in Egypt highlights the high prevalence of post-acute COVID-19 syndrome. The high prevalence of Post-COVID-19 pulmonary fibrosis and psychological disorders, particularly anxiety and depression, is a cause for concern. There was also a single report on post-COVID diabetes mellitus, stroke, migraine, and coagulative ocular disorders that need further investigation. To the best of our knowledge, this is the first systematic review and meta-analysis conducted at a national level to determine the prevalence and predictors of post-COVID syndrome. Larger studies with a longer follow-up period are still needed to confirm these findings and explore other potential risk factors and modifiers of the Post-COVID syndrome.
{"title":"Exploring the prevalence and factors associated with post-acute COVID syndrome in Egypt: a systematic review and meta-analysis","authors":"Ahmed Azzam, Heba Khaled","doi":"10.1186/s43162-023-00252-x","DOIUrl":"https://doi.org/10.1186/s43162-023-00252-x","url":null,"abstract":"Abstract Background Post-COVID-19 survivors may experience long-term symptoms known as Post-acute COVID-19 syndrome (PACS). The PCAS symptom spectrum includes a wide range of symptoms affecting different organs. The prevalence and risk factors of PACS may vary across different regions, and a meta-analysis focused on Egypt can help understand the national prevalence and unique population-specific predictors. Methods A comprehensive literature search was conducted following the PRISMA guidelines to identify studies published in Egypt that documented symptoms, signs, and post-COVID-19 outcomes in patient cohorts. The results were reported, based on the random effects model, as proportions (%) and odds ratios with 95% CI. Results A total of 16 studies with 3097 COVID-19 survivors and an age range of 3 to 94 years were included in the analysis. The pooled prevalence of COVID-19 survivors experiencing at least one persistent symptom, regardless of hospitalization status, was high at 78.3%. A total of 54 clinical symptoms or conditions were reported among the survivors. The most commonly reported symptom was fatigue, which affected approximately half of all survivors (48.1%). Bone ache or myalgia, anorexia, anxiety, dyspnea, and depression were also among the most frequently reported symptoms at 32.9%, 32.8, 31.5, 19.9, and 19.5, respectively. The pooled prevalence of Post-COVID-19 pulmonary fibrosis (PCPF) among hospitalized Covid survivors was 40%. The study found that female sex, severe COVID, and the presence of any comorbidity were independent risk factors for PACS ( P < 0.05). Conclusion This meta-analysis of 16 studies conducted in Egypt highlights the high prevalence of post-acute COVID-19 syndrome. The high prevalence of Post-COVID-19 pulmonary fibrosis and psychological disorders, particularly anxiety and depression, is a cause for concern. There was also a single report on post-COVID diabetes mellitus, stroke, migraine, and coagulative ocular disorders that need further investigation. To the best of our knowledge, this is the first systematic review and meta-analysis conducted at a national level to determine the prevalence and predictors of post-COVID syndrome. Larger studies with a longer follow-up period are still needed to confirm these findings and explore other potential risk factors and modifiers of the Post-COVID syndrome.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135536996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-18DOI: 10.1186/s43162-023-00251-y
Nour Mohammed Rasheed, Howaida Attia Nounou, Soad Mohamed Eltabakh, Nahla A. M. Hamed, Ayman Ahmed Darwish
Abstract Background Role of Long non-coding RNAs in cancer research in the recent years have been highlighted with evidence to their involvement in cancer disease pathogenesis and progression. One of these emerging long non-coding RNAs is differentiation antagonizing non-protein coding RNA (DANCR). DANCR distinct expression in different cancers and implication in tumor signaling pathways made it a promising therapeutic target for cancer. The purpose of this study was to evaluate DANCR expression in de novo acute myeloid leukemia (AML) patients and to assess DANCR expression in relation to cytogenetics and French American British (FAB) AML classification as well as correlate DANCR expression with patients’ response to treatment. The present study included 60 newly diagnosed AML patients and 30 healthy subjects as controls. Relative DANCR expression was done using real time qPCR method. Results DANCR was significantly downregulated in AML patients compared to controls ( p = 0.038). In addition, DANCR showed significantly lower expression in M4 and M5 compared to M0, M1, and M2 groups ( p < 0.001). Furthermore, DANCR expression was significantly downregulated in cytogenetically normal AML patients compared to the controls ( p = 0.011). Conclusion Significant downregulation of DANCR in AML suggests a potential tumor suppressor role and variable expression of DANCR among AML subtypes suggests that DANCR action may be different among AML subtypes. Also, M1 subtype patients with higher DANCR expression were less refractory to treatment and therefore less resistant to cytarabine.
{"title":"Assessing the expression of differentiation antagonizing non-protein coding RNA (DANCR) in newly diagnosed Egyptian acute myeloid leukemia patients","authors":"Nour Mohammed Rasheed, Howaida Attia Nounou, Soad Mohamed Eltabakh, Nahla A. M. Hamed, Ayman Ahmed Darwish","doi":"10.1186/s43162-023-00251-y","DOIUrl":"https://doi.org/10.1186/s43162-023-00251-y","url":null,"abstract":"Abstract Background Role of Long non-coding RNAs in cancer research in the recent years have been highlighted with evidence to their involvement in cancer disease pathogenesis and progression. One of these emerging long non-coding RNAs is differentiation antagonizing non-protein coding RNA (DANCR). DANCR distinct expression in different cancers and implication in tumor signaling pathways made it a promising therapeutic target for cancer. The purpose of this study was to evaluate DANCR expression in de novo acute myeloid leukemia (AML) patients and to assess DANCR expression in relation to cytogenetics and French American British (FAB) AML classification as well as correlate DANCR expression with patients’ response to treatment. The present study included 60 newly diagnosed AML patients and 30 healthy subjects as controls. Relative DANCR expression was done using real time qPCR method. Results DANCR was significantly downregulated in AML patients compared to controls ( p = 0.038). In addition, DANCR showed significantly lower expression in M4 and M5 compared to M0, M1, and M2 groups ( p < 0.001). Furthermore, DANCR expression was significantly downregulated in cytogenetically normal AML patients compared to the controls ( p = 0.011). Conclusion Significant downregulation of DANCR in AML suggests a potential tumor suppressor role and variable expression of DANCR among AML subtypes suggests that DANCR action may be different among AML subtypes. Also, M1 subtype patients with higher DANCR expression were less refractory to treatment and therefore less resistant to cytarabine.","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135152311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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