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Evaluation Of Neutrophils To Albumin Ratio (Nar) And C-Reactive Protein To Albumin Ratio (Car) As Markers Of Disease Activity In Patients With Ulcerative Colitis, Doaa Salah Abd-El-Fattah, Mohamed Abd El-Maksoud, Salwa M. Abo El-Khair, Ahmed El-Eraky, Amany Hasson

Mansoura Medical Journal

Background Ulcerative colitis (UC) is considered an extensive disease due to the risks of proximal extension, malignant transformation, disability and impaired life quality. This study aimed to explore the role of Neutrophils to Albumin Ratio (NAR) and C - reactive protein to Albumin Ratio (CAR) in evaluation of disease activity in patients with UC. Methods This cross-sectional study included 227subjects classified into two groups; group (I) included 126patients suffering from ulcerative colitis and group (II) included 101 healthy individuals with normal basic laboratory tests matched for age and sex. Estimating disease activity and severity clinically was according to Truelove criteria. …

Triglyceride Glucose Index As A Predictor Of Insulin Resistance In Patients With Hypothyroidism, Nadeen El-Nakeeb, Mohammed A. Helaly, Ahmad S. Hasan, Rania Bahriz

Mansoura Medical Journal

Background: Thyroid hormones play a key role in glucose metabolism, and hypothyroidism is frequently associated with impaired insulin secretion, altered glucose disposal, and insulin resistance (IR).

Aim: This study aimed to assess insulin resistance in patients with hypothyroidism using the triglyceride–glucose (TyG) index in comparison with the homeostasis model assessment of insulin resistance (HOMA-IR).

Methods: This case-control study was conducted on 100 participants (50 hypothyroid patients and 50 euthyroid controls), aged 18–60 years. All subjects underwent detailed clinical evaluation, anthropometric measurements, and fasting laboratory investigations including glucose, lipid profile, insulin, TSH, and free T4. Insulin resistance was assessed using TyG …

Impact Of Body Mass Index On Clinical Outcomes In Metastatic Breast Cancer Running Title: Impact Of Bmi On Mbc Outcome, Alaa Abdelrahman Sonbol, Maha Elzaafarany, Ahmed Albehairy, Sherif Refaat

Mansoura Medical Journal

Background: Body mass index (BMI) has been suggested as an important patient-related factor influencing treatment outcomes in breast cancer. This study aimed to evaluate the association between BMI categories and clinical outcomes among patients with metastatic breast cancer (MBC).

Patients and Methods: This retrospective study included 400 patients with MBC. Clinical outcomes assessed included response to first-line treatment, treatment-related toxicity, and status at last follow-up and BMI was calculated using the Quetelet index .

Results: Patients were characterized by a high prevalence of obesity and predominantly good performance status. Disease progression following first-line treatment was the most common …

Could Peri-Coronary Fat Thickness Predict Severity Of Pulmonary Covid 19 And Post Covid-19 Pulmonary Scarring?, Basma A El-Ged, Dalia Fahmy, Mohamed Hamoda, Mohamed Tohlob, Heba M Abou El-Atta

Mansoura Medical Journal

Objective: to study the correlation between peri-coronary fat thickness (PCFT) and clinical disease severity in patients with proved COVID-19, as well as post COVID-19 scarring.

Patients and methods: This retrospective comparative study included 202 patients with pulmonary COVID-19 who were referred for Chest High Resolution Computed Tomography (HRCT). Patients were further classified into Group A who had non-severe covid 19 disease and group B who had severe and critical disease according to WHO criteria. CT severity score (CSS), Total fibrosis score (TFS) and peri coronary fat thickness (PCFT) were evaluated and compared for both groups in the CT scans of …

Serum High Sensitivity Cardiac Troponin I Level And Its Relation To Severity Of Psoriasis Vulgaris, Aya Hassan Mohammed El-Shamy, Samia Mohammed Abdel Naby, Mohammed Fawzy El Sayed, Amany Ragab Youssef Ahmed

Mansoura Medical Journal

Background: Psoriasis is a chronic inflammatory skin disease affecting 2.5% of the worldwide population. Troponin I levels are accompanied by cardiovascular disease (CVD) risk in psoriatic cases. So, this study was conducted to detect serum levels of high-sensitivity cardiac troponin I (HScTnI) in psoriasis vulgaris (PV) cases compared to healthy controls. Methods: This case-control study included 40 cases with PV and 40 healthy subjects as a control group. Disease severity evaluation was conducted by using the psoriasis area severity index (PASI) score to classify the cases into groups according to severity. Measurement of HScTnI levels was conducted. Results: Mean HsCTn …

Clinical And Dermoscopic Nail Changes In Patients With Chronic Kidney Disease: A Cross-Sectional Study, Ghada Nagy Mansour Borham, Hassan Abdel-Raheim Fayed, Eman Nagy Ahmed Abdelrazik, Amany Awad Mohamed

Mansoura Medical Journal

Background: Nail abnormalities are commonly observed among patients with chronic kidney disease (CKD) and may reflect underlying systemic and metabolic alterations. Dermoscopy (Onychoscopy) has emerged as a valuable noninvasive tool for detecting subtle nail changes.

Aim:  To describe the patterns and dermoscopic features of nail changes in patients with chronic kidney disease (CKD) and to explore their association with disease severity and renal function parameters.

Methods: This cross-sectional descriptive study included 127 patients with different stages of CKD. All participants underwent a comprehensive clinical and dermoscopic evaluation of the nail apparatus. Dermoscopic findings included longitudinal ridging, white …

The Role Of Vitamin D In Management Of Pediatric Chronic Immune Thrombocytopenia, Eman Magdy Yahia, Suzy Abd El Mabood Abd El Hameed, Dalia Tawfeek Hussein, Amany Mamdouh Shoumah

Mansoura Medical Journal

In children, immune thrombocytopenia (ITP) remains a serious health concern, which is an autoimmune disorder (AID) characterized by an isolated decrease in platelet count, leading to an increased risk of bleeding.

The use of vitamin D supplementation represents a turning point in many autoimmune diseases, with the potential to deliver high cure rates with fewer side effects than previous therapies. In this review, we explore the incidence of ITP , immunopathogenesis, diagnosis and management in pediatric patients. We will discuss the mechanisms of action of vitamin D , focusing on its role in autoimmune diseases especially ITP

Demographic Characteristics In Patients With Heart Failure And Iron Deficiency, Ahmed Alaa Eldin Abd Elazeem, Abdul Razek Abdul Lateef Maaty, Hanan Ahmed Azzam, Ahmed Mohamed Reda

Mansoura Medical Journal

Background: Iron deficiency (ID) is a major and prevalent comorbidity among heart failure (HF) patients. It is associated with poor exercise tolerance, recurrent hospitalization and higher mortality. Studying patients’ demographics helps to determine vulnerable groups to ID, risk factors and associated comorbidities to be considered during screening and management.

Aim of the Work: To study the demographic characteristics of heart failure patients with iron deficiency.

Patients and Methods: A cross sectional observational study was conducted at a tertiary care university hospital at Delta region of Egypt between year 2024 and 2026. Among 117 HF patients, 100 HF patients …

Red Cell Distribution Width As A Prognostic Factor And Its Comparison With Lactate In Patients With Sepsis: An Observational Prospective Cohort Study, Ahmed Taha Gad, Ghada Fathy El-Rahmawy, Naglaa Abd El-Latif El-Negeery, Eiad Ahmed Ramzy

Mansoura Medical Journal

Background: Red blood cell distribution width (RDW) is a straightforward and cost-effective parameter that is utilized in laboratory hematology to differentiate anemias. It is indicative of the grade of heterogeneity in erythrocyte volume. This study purpose examine the correlation among the risk of adverse results in patients with sepsis and RDW, as well as to equivalence the mortality discriminative capacity of RDW and lactate levels.

Methods: This observational prospective cohort study was done on 67 sepstic patients aged ≥ 21 years old, both sexes. Patients were owed into two groups according to RDW levels: Group A (n=35): normal RDW …

Hypoalbuminemia As A Predictive Factor For Acute Kidney Injury In Pediatric Patients Running Title: Hypoalbuminemia In Aki Pediatrics, Kareem El-Saeed El-Maasrany, Ayman Hammad, Hosam Zaghloul, Ahmed Elhusseiny

Mansoura Medical Journal

Aim: Hypoalbuminemia is a well-known risk factor for illness and death, but its role as a particular predictor of acute kidney injury (AKI) is still not fully understood. This study intended to evaluate the role of hypoalbuminemia as a predictive factor for AKI outcome among pediatric patients, regarding hospital stay, kidney replacement therapy and mortality rate.

Subjects and Methods: This prospective observational cohort was conducted on 70 children with AKI divided into two groups: group I (35 AKI children combined with hypoalbuminemia) and group II (35 AKI children without hypoalbuminemia). All participants were subjected to full history taking, clinical examination …

Serum Magnesium Level And Carotid Artery Calcification And Stiffness In Dialysis Patients: Single Center Cross-Sectional Study, Kareem Ahmed Elbosaty, Alaa Abd Elaziz Sabry, Gehad Ahmad Saleh, Nehal Atef Elshabrawy

Mansoura Medical Journal

Introduction Vascular calcification is common among end-stage renal disease (ESRD) patients on regular dialysis, either hemodialysis or peritoneal dialysis. Magnesium is suggested to play a role in inhibiting that process. Recently, Mg started to be considered one of the factors that protect against vascular calcification and consequently decrease CVD mortality rate in CKD patients. Many recent studies support that role although the mechanism of that protective effect is not clear. But it is supposed to be a combination of both passive and active mechanisms. The passive one occurs through interference with calcium phosphate deposition and hydroxyapatite inhibition by phosphate binding. …

Evaluation Of Clinical Efficacy And Safety Of Topical Trifarotene Versus Topical Dapsone In Inflammatory Acne Valgaris: Split Face Interventional Study., Shaymaa E. Elmongy, Aya Mohammed Elsebaie, Azza Osama Alqurei, Noura A. Elseessy

Mansoura Medical Journal

Background: Topical Trifarotene and Dapsone both treat inflammatory acne, but they work differently and have distinct side effects.

Objective: to compare efficacy and safety between topical trifarotine 0.005% versus dapsone 5% gel for treatment of mild to moderate inflammatory facial acne vulgaris.

Methods: This split face interventional study included twenty (20) patients with mild to moderate facial acne vulgaris. All the patients were treated with topical trifarotine cream 0.005 once daily at night thin layer on RT side of the face and treated with topical dapsone gel 5% once daily at any time of the day thin …

Serum Zinc Levels In Children With Complicated Community Acquired Pneumonia: A Case-Control Study, Eslam Elhendawy, Angi Alwakeel, Shimaa R. Hendawy, Amal Osman

Mansoura Medical Journal

Background Zinc performs an important part in maintaining proper immune function, and its deficiency has been connected to an increased risk of severe respiratory infections. However, there is limited data on serum zinc concentrations in children suffering from complicated community-acquired pneumonia (cCAP), particularly within the Egyptian pediatric population. Objectives This study aimed to evaluate serum zinc levels in children diagnosed with severe cCAP in comparison to healthy controls and to assess the diagnostic effectiveness of serum zinc levels in distinguishing children with cCAP. Methods This study included 100 children with severe cCAP and 100 age- and sex-matched healthy controls enrolled …

Study Of Serum Zinc And Copper Levels In Type 2 Diabetic Patients With And Without Nephropathy, Hayam Elmetwally, Ahmed Almenshawy, Alaa Sabry, Rania Bahriz

Mansoura Medical Journal

Background: Diabetic Nephropathy (DN) is one of the most important microvascular complications of Diabetes mellitus (DM). The purpose of this study was to look at how changes in serum zinc and copper levels relate to the incidence of diabetic nephropathy in individuals with type 2 diabetes.

Methods: The type of the study is an observational case-control study. This observational case control study was conducted over a period of one year and included 90 adult subjects. Subjects were categorized into three equal parties. Patients without nephropathy who had type 2 diabetes were included in Group I (n=30) . Patients …

Examining Firefighter Perceptions Of Stress And Recovery Across A Shift And Engagement In Recovery Activities, Nathan T. Ebersole

College of Graduate Studies: Theses & Dissertations

The occupational demands of firefighting, such as fire suppression and rescue tasks, working in hazardous conditions, inconsistent sleep patterns, and exposure to traumatic events, can lead to work-related injuries, burnout, and feelings of isolation. To date, there is limited research on the impact of a single work-shift on firefighter perceptions of stress and recovery and the recovery activities that may influence these perceptions. Thus, the purpose of this study was to examine the effect of a single work-shift on firefighter perceptions of stress and recovery status as well as the recovery activities firefighters choose to engage in. Forty-three firefighters across …

Maternal Healthcare In The United States: An Exploration Of The Organizational And Political Determinants Of Maternal Healthcare Quality And Outcomes, Tamaya S. Browder

College of Graduate Studies: Theses & Dissertations

Despite having an advanced U.S. healthcare system, childbirth remains risky in the US, especially for socially vulnerable populations. Medicaid covers a large portion of births and is equipped to implement large-scale interventions to improve maternity care and patient outcomes. Two studies were conducted to (a) examine the relationship between organizational factors in U.S. hospitals and adverse clinical outcomes among Medicaid-insured maternity patients, and (b) analyze state-level Medicaid bundled payment models for maternity care. Guided by the Donabedian Quality of Care Model, Study One used logistic regression on data from the 2018-2020 National Inpatient Sample to explore how hospital organizational factors …

From Vision To Impact: Strategic Planning For The South Health District, Jason D. Butler Jr

College of Graduate Studies: Theses & Dissertations

This study presents a community health assessment and strategic planning process for the South Health District (SHD), a rural, multi-county public health district.  Using a mixed-methods approach, quantitative surveys and qualitative data from County Nurse Managers, County Boards of Health, and internal staff were integrated with secondary sources to identify community health priorities and organizational gaps.  Broad stakeholder engagement through surveys, SWOT workshops, and town-hall meetings ensured credibility and contextual relevance.

Findings revealed challenges in behavioral health, substance abuse, chronic disease, access to preventive services, transportation, workforce capacity, communication, and infrastructure.  Four strategic issues—Communication, Workforce Development and Retention, Purpose-Driven District, …

Effects Of The Menstrual Cycle Phase On Rpe, And Symptom Characteristics In Pre-Professional Female Soccer Players, Emily Potts

College of Graduate Studies: Theses & Dissertations

Hormonal fluctuations across the distinct phases of the menstrual cycle have been shown to influence physiological and psychological responses to exercise, with some evidence suggesting phase-dependent changes in symptom presentation and ratings of perceived exertion (RPE); however, findings remain inconsistent, and few studies have examined these relationships across an entire competitive season in female soccer players. The purpose of this study was to examine changes in RPE and menstrual symptoms across cycle phases, as well as the relationships between RPE and symptom reporting in pre-professional female soccer players. A total of 22 female soccer players (age 22± 1.85) were recruited …

Body Image Perception In African American Women, Ages 20-55 Years, Trina Suttles

College of Graduate Studies: Theses & Dissertations

This qualitative study explored the factors that influence body image perception among African American women in the metropolitan Atlanta, Georgia area and examined how these perceptions shape physical activity and dietary behaviors. Body image perception is a critical psychocultural factor influencing obesity-related behaviors, particularly among African American women who navigate culturally specific beauty standards and health beliefs. Guided by the Socioecological Model, this study addressed three research questions: (1) how African American women perceive their body image, (2) how these perceptions influence health behaviors, and (3) what multilevel factors shape body image perceptions. This study employed consensual qualitative research (CQR) …

What Is The Evolving Role Of Nurses In Telehealth As Future Healthcare Professionals?, Emma G. Lowry

Honors College Theses

Telehealth has evolved into an essential component of healthcare delivery in today's world, something that occurred alongside the COVID-19 pandemic. As healthcare professionals, nurses must be adequately prepared and equipped to use the tools for telehealth. This paper examines the evolving role of nurses in telehealth by assessing undergraduate nursing students’ and practicing nurses’ knowledge, attitudes, and perceived competencies. Data will be collected through a Qualtrics survey utilizing the Awareness, Knowledge, Attitude, and Skills (AKAS) Scale for Telemedicine, supplemented by interviews with telehealth practitioners to provide qualitative context. It is expected that variations in proficiency and attitudes, from previous biased …

Bridging The Gap Between Function-Based And Iddsi Standards In Dysphagia Care, Chien-Hui Cheng

Rehabilitation Practice and Science

No abstract provided.

A Scoping Review Of Non-Instrumental Dysphagia Screening Tools: Building Flowcharts To Guide Tool Selection, Yu-Chun Chang, Ming-Jhuan Wang, Shu-Fen Siao, Yu-Juan Xu, Meng-Shan Wu, Tyng-Guey Wang, Cheryl Chia-Hui Chen

Rehabilitation Practice and Science

Selecting an appropriate non-instrumental dysphagia screening tool is a complex process. This scoping review aimed to identify dysphagia screening tools with established reliability and validity, and to develop administrator-based flowcharts to guide tool selection across different clinical populations. A scoping review was conducted using studies identified in CINAHL, Embase, PsycINFO, PubMed, and Web of Science. Our search was guided by five keywords: “dysphagia,” “deglutition,” “screening,” “test,” and “measure.” Original studies about the development and validation of non-instrumental dysphagia screening tools were selected. Six reviewers were involved in the review process, and at least two reviewers independently completed each step of …

Perception Of Dementia Risk Among Black Adults: An Ecological Analysis Of Causal Loop Diagrams With A Structural And Social Determinant Of Health Composite Index, Jean-Francois Trani, Ramkrishna K Singh, Alexis Ib Walker, Semere Bekena, Yiqi Zhu, Ganesh M Babulal, Robbie Hart

2020-Current year OA Pubs

INTRODUCTION: To investigate drivers of dementia risk disparities among older Black Americans using a community-based system dynamics (CBSD) approach.

METHODS: Over 18 months, 234 participants created 36 causal loop diagrams (CLDs) on dementia risk. An ecological analysis compared structural differences across groups based on scores on a structural and social determinants of health composite index (S/SDOH-CI).

RESULTS: Groups in the highest SDOH-CI quantile were more likely to identify key protective pathways linking mental health, substance use, exercise, medication, and community support to reduce dementia risk. In contrast, fewer than 25% of low-SDOH-CI groups identified these connections, and under 15% recognized …

Identifying The Physical Activity Promotion Practices Of Obstetricians And Gynecologists: Patients With Endometriosis And Polycystic Ovary Syndrome, Allison P. Herman

Theses and Dissertations (Comprehensive)

Despite efforts to promote physical activity, many females in Canada do not meet recommended physical activity guidelines. For individuals with gynecological conditions such as endometriosis and polycystic ovary syndrome (PCOS), physical activity may aid in symptom management and improve daily functioning. Healthcare settings, including obstetrics and gynecology, represent an area of opportunity to promote physical activity among this population. This thesis aims to understand the physical activity promotion practices of Ontario-based Obstetricians and Gynecologists (OBGYNs) to patients with endometriosis and/or PCOS. A cross-sectional online survey was conducted to explore OBGYNs promotional practices and perceived factors influencing their engagement in physical …

Treating Alzheimer's Disease In A Person Living With Hiv, David B Clifford, Tammie L S Benzinger, Jee-Young Han, Savannah Powles, Madeline Paczynski, Beau M Ances, J William Campbell

2020-Current year OA Pubs

INTRODUCTION: Human immunodeficiency virus (HIV) therapies now support survival into advanced ages by suppressing HIV replication and preserving immune function. Alzheimer's disease (AD), the most common neurologic degenerative condition, may now be treated with anti-amyloid therapies (AAT). HIV was an exclusionary criterion in clinical trials for AAT, leaving the safety and efficacy of these medications unknown in this setting.

METHODS: We report the development of AD supported by careful evaluations and biomarkers over a 10-year period in a person living with well-controlled HIV infection.

RESULTS: AD was diagnosed with consistent clinical and biomarker evidence. AAT was successfully administered without complications. …

Biological Aging Acceleration In Major Depressive Disorder: A Multi-Omics Analysis, Breno Satler Diniz, Shangshu Zhao, Gabin Drouard, Eero Vuoksimaa, Miina Ollikainen, Eric J Lenze, Ming Xu, Richard H Fortinsky, George A Kuchel, Jaakko Kaprio, Chia-Ling Kuo

2020-Current year OA Pubs

Major depressive disorder (MDD) is linked to a higher risk of premature aging, but the mechanisms underlying this association remain unclear. Using data from two population cohorts (UK Biobank and Finnish Twin Cohort), we evaluate the relationship between systemic and organ-specific proteomic and epigenetic aging acceleration and MDD. A lifetime history of MDD was associated with accelerated proteomic aging at both systemic and organ-specific levels-including the brain-in both cohorts, with stronger associations than those observed with systemic epigenetic aging. Systemic and brain-specific proteomic aging acceleration were linked to higher risks of incident MDD and a greater risk of Alzheimer's disease, …

Sleepiness In Pregnancy And Adverse Perinatal Outcomes, Rachel Friedlander, Xiaoning Huang, Phyllis Zee, Sadiya S. Khan, Philip Greenland, Francesca L. Facco, Judith Chung, William A. Grobman, Shalini Manchanda, Uma M. Reddy, George R. Saade, Robert M. Silver, Lynn M. Yee

Department of Obstetrics & Gynecology Faculty Publications

Background

Sleep disorders in pregnancy have been associated with adverse pregnancy outcomes including hypertensive disorders of pregnancy, preterm birth, and gestational diabetes mellitus, yet these findings are largely from retrospective studies. Using data from a prospective study that used validated tools to assess sleepiness in pregnancy, we aimed to assess the association of sleepiness in pregnancy with adverse pregnancy outcomes.

Methods

In this secondary analysis of data from a large, diverse prospective cohort of nulliparous individuals conducted at eight United States medical centers, those with self-reported sleep data were included. Sleepiness was evaluated in early (6-13 weeks) and mid-pregnancy (22-29 …

The Association Between The Degree Of Social Vulnerability And Maternal Anemia And Other Adverse Perinatal Outcomes, Rubymel J. Knupp, Christina T. Blanchard, Ariann Nassel, Ashley Shea, Lindsay S. Robbins, Jeff M. Szychowski, Ashley N. Battarbee, Akila Subramaniam

Department of Obstetrics & Gynecology Faculty Publications

Objective

Maternal anemia in pregnancy is associated with many adverse maternal, fetal, and neonatal outcomes. The role of social determinants of health (SDOH) in the development of maternal anemia and other adverse outcomes is continually evolving. One such newer tool, the Social Vulnerability Index (SVI), measures an individual's community-level SDOH, with higher SVI denoting higher vulnerability. Our objective was to evaluate the association between SVI, maternal anemia, and other adverse perinatal outcomes.

Methods

Retrospective cohort study of pregnant individuals delivering singletons at a gestational age ≥23 weeks at a single center from 2014 to 2018. Patients with sickle cell disease, …

Evaluating The Mediating Role Of Gestational Phthalate And Replacement Biomarkers In The Associations Between Race/Ethnicity And Birthweight, Amir J. Lueth, Danielle R. Stevens, Sarahna A. Moyd, Elena Sinkovskaya, Ann Przybylska, Antonia M. Calafat, Julianne C. Botelho, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Background

Gestational exposure to phthalates is higher among non-Hispanic black (NHB) women than non-Hispanic white (NHW) women and may contribute to racial/ethnic differences in birthweight z-scores.

Objective

We aimed to investigate whether gestational phthalate and replacement biomarkers mediate the association between race/ethnicity and birthweight z-scores.

Methods

We analyzed data from 271 pregnancies in the Human Placenta and Phthalates study, a prospective cohort recruited from 2017 to 2020. Urinary phthalate metabolite concentrations were measured at up to eight time points during pregnancy and averaged to represent gestational exposure. Metabolites were grouped by parent compound. Linear regression models estimated associations in phthalate …

Trends In Glp-1 Based Therapy Use Before And After Pregnancy, Nansi S. Boghossain, Lauren Mcabee, Antonio F. Saad, Maged M. Costantine, Marwan Ma'ayeh, Joseph A. Ewing

Department of Obstetrics & Gynecology Faculty Publications

[Introduction] Glucagon-like peptide-1 (GLP-1)-based therapies are increasingly prescribed for the treatment of type 2 diabetes and obesity, with rapid uptake of newer agents such as semaglutide and tirzepatide [1, 2]. These medications improve glycemic control and promote weight loss and are now widely used among reproductive-aged individuals [2, 3]. However, GLP-1-based therapies are typically discontinued prior to pregnancy because of limited safety data and potential fetal risks, and current guidance recommends avoiding use during pregnancy [3]. As prescribing expands, a growing number of individuals entering pregnancy may have recent exposure to GLP-1-based …