Abstract Background Androgenetic alopecia (AGA) is the most common type of hair loss in men. It is commonly known as a male pattern baldness. It is characterized by a stepwise miniaturization of the hair follicle, resulting from alteration in the hair cycle dynamics, leading to vellus transformation of terminal hair follicle. In AGA, the duration of anagen phase gradually decreases and that of telogen phase increases, the maximum length of the new anagen hair becomes shorter than that of its predecessor, leading to miniaturization and eventually a bald appearance. Aim of the work To assess the expression of NRF2 in the scalp of men with androgenetic alopecia. Patients and Methods This case control study included 28 male patients whose age ranged from 18 to 45 years old. They were diagnosed as having AGA according to Norwood-Hamilton scale. Further, 28 age and sex matched healthy male controls were recruited. All patients and controls were recruited from the dermatology outpatient clinic of Ain-Shams University Hospitals, during the period of September 2018 to April 2019. Results A group of Twenty-eight male patients with AGA were recruited to the study. The of patients ranged from 18 to 45 years (mean = 33.46 years ± 9.9 SD). Twenty-eight age matched male healthy volunteers without AGA were e recruited. The majority of AGA patients had positive family history of AGA in their first degree relatives. None of our patients had a medical history of systemic diseases like diabetes mellitus or hypertension. Conclusion The current study showed that alteration of Nrf2 levels may play an important role in the pathogenesis of AGA.
Background: Acne vulgaris is a multifactorial disease, studies have focused on the role of oxidative stress in the aetiopathogenesis of acne.Malondialdehyde (MDA) is a good marker of oxidative stress.Intense pulsed Light (IPL) systems are used in treatment of acne, the mechanism is reduction of Propionibacterium acnes (P.acnes) levels, decrease in the sebaceous gland function.Objective: The study objective was to estimate the efficacy of IPL on levels of oxidative stress in acne patients taking MDA levels as an indicator before and after IPL.Subjects and Methods: An interventional study was carried out on 20 patients with acne and 20 individuals free of acne.The severity of acne was assessed using the Global Evaluation Acne (GEA) scale.The levels of MDA were measured before the first IPL session and after 2 weeks from the last session using a spectrophotometer.Each patient received 3 IPL sessions biweekly.MDA levels in the acne free group was measured and compared to that of cases.Results: MDA levels showed a statistically significant difference among patient after IPL treatment compared to levels before IPL treatment with the lower levels in after IPL treatment.MDA levels showed a statistically significant difference between patients and acne free individuals, with MDA being higher in patients, indicating a condition of oxidative stress that had resulted from a high level of lipid peroxidation in acne patients.As regard MDA levels, patients with moderate acne showed the higher plasma MDA levels compared with those with mild acne.The lowest MDA levels were observed in acne free individuals.Conclusion: Serum MDA level is elevated in patients with acne than in acne free individuals.IPL can be used as a monotherapy in acne, especially in inflammatory lesions.IPL is effective in reducing oxidative stress in acne.
Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs.A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively.A total of 2447 HCWs participated; 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs; the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20%; the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63%; the lowest rate was reported in Libya (28%) and the highest in Syria (76%).COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered.
Surgical methods are favorably used for treatment of stable vitiligo, and platelet-rich plasma (PRP) can be added to augment the effect. The additive value of PRP, however, remains elusive. Basic fibroblast growth factor (bFGF) is released from activated platelets with a capacity for stimulating melanocyte proliferation and migration. The treatment outcomes for the mini-punch grafting (MPG)/phototherapy treatment with and without PRP were assessed and the relation between bFGF and the obtained results were evaluated. Thirty-four vitiliginous patches, two per each patient with stable vitiligo, were enrolled in this intrapatient-controlled study and treated with autologous MPG and subsequent exposure to phototherapy with and without enhancement via PRP procedure at the time of the procedure, and monthly for the subsequent 3 months. Re-pigmentation assessment via vitiligo scores as well as measurement of lesional bFGF were done. PRP assistance to MPG/phototherapy treatment resulted in earlier re-pigmentation at week 8. However, this enhancement effect vanished at the study end (week 20) as ideal re-pigmentation (>75% re-pigmentation) was encountered in 10 patches (58.8%) treated with MPG/phototherapy modality, and in 12 patches (70.6%) treated with PRP-assisted method without significant difference between them. Lesional bFGF increased after both treatments with a higher expression with PRP assistance but without clinical reflection on the final outcome. PRP can speed the re-pigmentation response for MPG/phototherapy procedure without any significant effect on the final outcome.
Background: Endometrial carcinoma ranks second among the most common gynecological malignancy in developing countries. Biomarkers are needed to aid in screening the disease and predicting the clinical as well as the therapeutic outcome. Human Epididymis Protein 4 (HE4) is a protein that was first isolated from human epididymis cells. HE4 levels are elevated in various types of cancers, such as ovarian and gastric cancer. Objectives: We aim to assess the association of serum and tissue, HE4, and endometrial adenocarcinoma in 77 Egyptian patients divided into two groups: 37 patients in the endometrial cancer group and 40 patients in the control group. Results: We found that HE4 levels were significantly increased in both serum and tissue of the endometrial cancer group compared to the negative control group. Moreover, higher expression levels were significantly associated with high-grade tumors. HE4 showed excellent diagnostic and prognostic value with a sensitivity and specificity of over 90 percent. Conclusion: We conclude that both serum and tissue expression of HE4 are sensitive, specific diagnostic and prognostic biomarkers in endometrial adenocarcinoma. In addition, they can predict extra- uterine involvement and staging of the disease. Clinical Trial Registration No:: PRS-NCT03456791.
Background: Acute kidney injury (AKI) is common in ICU patients, leading to longer hospitalizations and higher mortality. Early detection and prevention are key to improving outcomes. This study aimed to assess pNGAL and SCysC as early diagnostic and prognostic markers for AKI severity, and mortality. Methods: This prospective observational study included ICU patients with septicemia, heart failure, ketoacidosis, and those on nephrotoxic drugs like aminoglycosides. Serum creatinine, pNGAL, and SCysC were measured within 4-h of admission, then at 24-h and 48-h for pNGAL and SCysC. SCr was monitored for 7 days. Results: Plasma NGAL and SCysC were significantly elevated in AKI patients as compared with non-AKI patients; at baseline, 24-h and at 48-h (p<0.001), demonstrating good sensitivity and specificity (AUC of 0.913 and 0.888 at baseline, respectively). PNGAL and SCysC levels were significantly correlated with serum creatinine. Plasma NGAL and SCysC levels were highly significant in deceased patients and patients with multiple comorbidities. Conclusion: pNGAL and SCysC are promising biomarkers for AKI. They can predict AKI in our setting before SCr levels rise, enabling timely interventions to help reduce the associated mortality and morbidity. Elevated pNGAL and SCysC in patients with multiple comorbidities may indicate worse prognosis and severity. Monitoring these markers in ICU patients with multiple comorbidities can help prevent irreversible kidney injury.
Background: Acute myeloid leukemia (AML) is a clonal hematopoietic malignancy, in spite of the marked improvement in the treatment of AML; Molecular biomarkers open the door to improve disease outcome. Accumulating evidence suggested that the long non-coding RNA “HOTAIR” has an oncogenic role in hemopoietic malignancies. Recently, it has been evident that knockdown of HOTAIR inhibits cell proliferation and induces apoptosis by modulating c-Kit expression via acting as competing for endogenous RNAs (ceRNAs) to sponge miR-193a at the post-transcriptional level. Objectives: we aimed to evaluate the diagnostic and prognostic value of HOTAIR in AML, to investigate its association with and c-Kit and miR-193a. Subjects & Methods: we examined the expression levels of HOTAIR, miR-193a, and c-Kit in 100 de-novo AML patients using quantitative, the association of genes expressions with risk factors and patient’s outcome were statistically analyzed. Results: the expression of HOTAIR was significantly upregulated by four folds in AML compared to healthy controls; higher expression levels were associated with high-risk factors, poorer overall survival (OS) and shorter leukemia-free survival (LFS). In addition; a negative correlation was detected between Lnc-HOTAIR and miR-193a, although significance didn’t reach. Conclusion: The obtained results suggested that HOTAIR expression was upregulated in peripheral blood samples of de-novo AML patients and was associated with leukemic burden and disease outcome. Therefore, it may represent an effective diagnostic and poor prognostic tool for AML.
Background: Several studies have described the benefits of LASER when used for crown lengthening (CL).However, there has been a lack of clinical trials comparing surgical functional crown lengthening (FCL) and LASER flapless CL.The aim of this study was to compare both methods together in terms of soft-tissue wound healing, gingival marginal stability and sub-gingival bacterial load reduction. Subjects and methods:Twenty patients with eligible teeth for FCL were recruited and randomly allocated to either; Group I: 10 posterior teeth indicated for FCL received closed flap laser assisted CL utilizing (Er, Cr:YSGG) laser or Group II: 10 posterior teeth indicated for FCL received open flap conventional surgical technique.Soft tissue healing was evaluated on the 7 th day,45 th day and after 3 months.Gingival marginal stability was evaluated immediately after surgery and after 3 months.Sub-gingival bacterial load was assessed at base-line, on the 7 th day and after 45 days.Results: Laser induced faster and significantly better soft tissue healing at 7 days but insignificantly less frequent stable gingival margin after 3 months when compared to conventional surgery.Laser induced significantly higher percentage reduction of bacterial load in the gingival sulcus than conventional surgery after 7 and 45 days. Conclusion:Closed flap laser-assisted CL using Er, Cr: YSGG laser can be used as an alternative procedure for conventional surgical FCL with better and faster healing and bacterial disinfection.
Introduction:Ionizing radiation (IR) is an occupational hazard that can induce many biological effects on exposed health care workers (HCWs).However, the health risks of low dose (below 100mSv) are controversial due to a lack of direct evidence on human.Aim of work: To identify the adverse health effects of exposure to low dose of ionizing radiation on general health status of health care workers at Ain Shams University hospitals.Materials and methods: A comparative cross-sectional study was conducted including 50 HCWs from different departments of Ain Shams University hospitals: exposed group (exposed to IR for at least I year) (No=25) and matched unexposed control group (No =25).Both groups were interviewed using a structured questionnaire.Complete blood count was done for both groups.Recording readings of personal exposure to IR by badge film dosimeter was done after approval from workplace authority.Results: Regarding general health status and wellbeing of workers, most of exposed group had perception of average health status, while most of unexposed group had perception of good health status.Significantly higher sickness absenteeism during the last 6 months was found among the exposed group.A significant adverse health effects, were recorded among exposed compared to control group as hair fall, musculoskeletal pain, pain in upper abdomen, constipation, decreased visual acuity, in addition to be easily agitated.During the last 30 days exposed group had significantly higher frequencies of GIT disturbances and common cold or infections in comparison to unexposed group.Results showed that the Mean Corpuscular Hemoglobin (MCH), absolute lymphocyte and monocyte counts were significantly lower while relative basophils % was significantly higher among exposed in comparison to unexposed group (although all parameters were within normal range in both groups).Conclusion and recommendations: Chronic exposure to IR -even in small dose-may lead to significant health complains (adverse health effects) and may affect general health status among exposed group compared to the control one.Personal monitoring for ionizing radiation, periodic medical examination, and increasing level of protection for exposed workers are of utmost importance.
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