bluuebunny/crossref_metadata_2025 huggingface dataset:
Emotional State among Parents of Children with Type 1 Diabetes and its Association with Disease Control
Authors: Shaaban Amira Rizk , El-Sehrawy Tarek Mohammed , Hashem Reem El-Sayed , ElNahas Gihan Medhat
Published: November 2024

Background

Type 1 diabetes is one of the commonest chronic childhood diseases. It can be diagnosed at any age; peaks in onset occur between 5 and 7 years of age and near puberty. The aim of this work was to assess psychological distress in parents of children with T1DM in comparison to parents of non-diabetic children and to assess the impact of parent's stress on control of diabetes on their children.

Methods

This comparative cross-sectional study was carried out on 105 parents of children diagnosed with type 1 diabetes recruited from diabetes clinic and 105 parents of non-diabetic children recruited from general paediatric clinic, age of parents was from 25 to 45 years and of child was from 2 to 5 years, both sexes. Participants were divided in to two equal groups: group A: parents of children diagnosed with type 1 diabetes (case group). Group B: parents of non-diabetic children (control group).

Results

There was statistically significant increase in the percentage of parents with moderate stress in cases group [83 (79%)] than in control group [68 (65.4%)] and also increase in the percentage of severe cases in control group [29 (27.9%)] than cases group [10 (9.5%)] with p-value = 0.002. Also, no statistically significant difference found between both groups regarding assessment of anxiety by Hamilton anxiety rating scale with p-value = 0.420. While there was statistically significant increase in the percentage of parents with severe depression assessed by Beck depression Inventory II among parents of cases group [27 (25.7%)] than parents of control group 1 (1%) with p-value <0.001. While there was statistically significant increase in the percentage of parents with no depression assessed by Beck depression Inventory II among parents of cases group [40 (38.1%)] than parents of control group 0 (0%) with p-value <0.001. There was statistically significant positive correlation between perceived stress scale and Hamilton anxiety rating scale and also Beck depression inventory scale. Also, there was statistically significant positive correlation found between Hamilton anxiety rating scale and beck depression inventory scale.

Conclusions

Parents of diabetic children are at increased risk for stress, depression and anxiety which in turn negatively affect control of diabetes in children.
Correlation between Headache and COVID-19 Infection
Authors: Khalil Salma Hameed , Farag Shereen Mohammed , Sakr Mohammed Abdelfattah , Youssef Aya Elsayed Mohammed Ali
Published: November 2024

Background

In Wuhan, China's Hubei Province's capital, 1st cases of unidentified severe pneumonia had been noted in December2019. On March 11, 2020, WHO formally dubbed the illness Coronavirus Disease 2019 & called it a pandemic. Numerous respiratory viruses are found to be able to invade the CNS over time (neuroinvasion). majority of them can cause neurological illnesses by infecting neurons & glial cells (neurotropism).

Objective

To assess the relationship between COVID-19 severity & headache characteristics & The secondary goal had been to look for any linkage among the occurrence of headache & disease severity.

Patients and Methods

This research had been conducted on50 studied cases suffering from headaches within 6 months after diagnosis of Covid-19 according to ICDH-III criteria of headache, with a mean age of 44.68 ± 18.33 years, with female predominance (60%).

Results

60% of patients had a worse headache with fever, 24% fever had no effect on headache and 16% fever decreased with headache. Paracetamol use induced headache improvement in 76% of the study patients, while in 24% no effect was observed. Headache onset had a highly significant correlation with fever, while headache onset had an insignificant correlation with paracetamol use. In current research, birth date and gender had insignificant effects on headache onset, frequency, and duration. COVID-19 severity had a highly significant effect on headache onset. Headache severity and frequency among this study's participants showed highly significant differences as regards headache onset. However, headache duration had an insignificant correlation with headache onset. In the present study, age had a highly significant relationship to COVID-19 severity. Sex showed a non-significant relationship to COVID-19 severity.

Conclusion

COVID-19 infection severity had a highly significant correlation with post-COVID headache onset, severity, and frequency. Also, it has a significant relationship to headache duration. The birth date has a significant relationship to post-COVID headache characters; however, gender has a non- significant relationship to post-COVID headache onset, severity, frequency, and duration.
Personality Disorders in Patients with Major Depressive Disorder and Association to Suicide
Authors: Rizk Enas Shafaey Mohamed , Omar Abd El Nasser Mahmoud , Awaad Mona Ibrahim , Hashem Reem El Sayed Mohamed
Published: November 2024

Major depressive disorder ranks as the fourth leading cause of disability worldwide and is one of the most common psychiatric disorders. Personality disorders, though less common than MDD, also appear highly prevalent. Several studies have examined the prevalence of suicidal behaviors in patients with MDD, but the prevalence range varied widely from 7.3to 48.4%.

Objective of the Study

This study aimed to assess type of PD among MDD patients, study the association between presence of PD co-morbid with MDD and level of functioning of the patients, investigate the relationship between PDs and risk of suicide in patients with MDD.

Patients and Methods

This Cross-sectional observational study included 120 patients diagnosed as MDD according to SCID-I assessment DSM IV were recruited then they were assessed severity of depression using Hamilton Depression Rating Scale and tested for the presence of Personality Disorders using SCID-II and assessed level of functioning according to GAF, and suicidality using Columbia- Suicide Severity Rating Scale assessment.

Results

Comorbid personality disorder was detected in 67.5% of patients (16.6% of patients had single comorbid personality disorder, while 50.8% of patients had Mixed PD). The most diagnosed PDs were Cluster B PDs (borderline personality disorder and narcissistic personality disorder) followed by Cluster C PD avoidant personality disorder (73.3%, 66.7%, 54.2% of patients respectively). Mixed PD had significant effect on level of functioning GAF of the MDD patients. Mixed PD had significant effect on suicidal thoughts and suicidal attempts.

Conclusion

Personality disorders showed significant impact on mental health status particularly depressive manifestations. Moreover, personality disorders and MDD exert marked effect on patients’ functionality and increase chance of suicidality.
Quality of Life (QOL) of Egyptian Patients with Amyotrophic Lateral Sclerosis (ALS) during the Pandemic of COVID-19
Authors: Allam Khaled Atef Elsyed , Fahmy Nagia Ali , Tork Mohamed Amir , Rashed Hebatallah Reda
Published: November 2024

Background

Amyotrophic lateral sclerosis (ALS), often referred to as Lou Gehrig’s disease, is a neurodegenerative disease of the upper and lower motor neurons, resulting in muscular atrophy and spasticity. It is a progressive, incurable illness with a mean survival from time of diagnosis of only 1–3 years.

Aim of the Work

Therefore, this research aimed to study the QOL and functionality of sample of Egyptian patients with ALS during the pandemic of COVID-19.

Patients and Methods

This cross-sectional study was conducted at Ain Shams University, in the period between August 1st, 2020, and March 30th, 2021. It included 74 patients recruited from neuromuscular unit Ain Shams University.

Results

There was a statistically significant negative almost perfect correlation between total scores of ALSAQ-40 and ALSFR-R questionnaires. There was statistically significant negative almost perfect correlation between total scores of ALSAQ-40 and ALSFR-R questionnaires four domains i.e. bulbar, fine motor, gross motor, and respiratory. There was a statistically significant positive correlation between total scores of ALSAQ-40 and age of the studied patients. There was no significant correlation between ALSAQ- 40 and time since disease onset. There was statistically significant association between total score of ALSAQ- 40 and gender of patients, where females had higher score than males. There was no statistically significant association between total score of ALSAQ-40 and special habits of patients. There was a statistically significant association between total score of ALSAQ-40 and presence of comorbidities (chronic illness, hypertension and diabetes) among the studied patients. Patients with chronic illness, hypertensives and diabetics had significantly higher scores (worse QoL). There was a statistically non-significant association between total score of ALSAQ-40 and disease type. There was a statistically significant association between total score of ALSAQ-40 and disease onset among the studied patients. Patients with bulbar onset had significantly higher scores (worse QoL). There was a statistically significant increase in total ALSAQ-40 scores after COVD-19 infection among the studied patients while there is statistically significant decrease in ALSFRS-R scores after catching COVID-19 infection. There was a non-significant correlation between time since onset and Quality of life as assessed by ALSAQ-40 and ALSFRS-R.

Conclusion

The COVID-19 pandemic affected QoL of Egyptian patients with ALS. ALS patients were affected by restriction measures during COVID-19 pandemic.
Mental Health Status of Patients with Bipolar Disorder during COVID-19 Lockdown, A Case Control Study at El Khanka Psychiatric Hospital
Authors: El-Shahawi Heba H , El Ghamry Reem H , Gabrielle Feby F , Basha Marwa Y
Published: November 2024

Background

The COVID-19 pandemic necessitated a number of measures including lockdown and social distancing. These measures affected mental health in healthy individuals and mentally affected patients. Individuals with bipolar disorder (BD) constitute an especially vulnerable group and studies focusing on effects of these measures are still lacking. The current study aimed to assess the mental health status of BD patients during the pandemic, particularly as regard increasing the risk of relapse and appearance of other psychiatric comorbidities and to assess and compare the immediate stress and psychological impact experienced by patients with BD and people without psychiatric illnesses during the pandemic.

Results

A total of 103 participants were included in the study, 50 in the cases group and 53 in the control group. Concerning demographic data, there was statistically significance difference between the two groups regarding gender, marital status, education, employment and socio-economic status. Study of COVID-19 impact on psychometric data revealed significantly higher score of IES-R in controls compared to cases. Comparison of COVID-19 affected cases and COVID-19 not affected cases revealed statistically significant association between IES-R median score result and COVID effects.

Conclusion

There was no significant difference between cases and controls regarding scales of depression, anxiety or insomnia. However, COVID-19 related containment measures significantly affected routine life stress and acute stress.
Thrombophilia Gene Testing in Patients with Ischemic Stroke of Undetermined Aetiology
Authors: Eid Mohamed Hamam Mohamed , Salah Nahed , Khawas Hala El , Atiah Amr Saeed
Published: November 2024

Background

Ischemic stroke of undetermined aetiology represents a large patient group as it involves approximately 17% of all ischemic stroke patients. Thrombophilia testing is frequently conducted in ischemic stroke of undetermined aetiology cases despite uncertain evidence on its association with stroke risk. Genetic factors such as Factor V Leiden and prothrombin gene mutations are studied, with unclear clinical impact. Racial variations influence thrombophilia prevalence. Efficient testing strategies targeting high-risk subgroups, such as ischemic stroke of undetermined aetiology patients, are sought to improve diagnostic yield and cost-effectiveness. However, the role of inherited thrombophilias in arterial thrombosis, while potentially significant, requires further elucidation due to the multifactorial nature of arterial ischemic stroke. These factors highlight the complexity surrounding thrombophilia testing and its utility in ischemic stroke management and prevention.

Aim of the Work

To evaluate the association between thrombophilia genes polymorphism and patients with ischemic stroke of undetermined aetiology.

Patients and Methods

This prospective analytical study conducted at Ain Shams University Hospital aimed to analyze thrombophilia gene abnormalities in 45 ischemic stroke of undetermined aetiology patients over a one-year period. Thrombophilia gene analysis included 12 gene variants. Data analysis utilized SPSS version 26 with a significance level set at p < 0.05. Ethical approval and informed consent were obtained. The study assessed the presence of thrombophilia gene abnormalities in ischemic stroke patients with unknown etiology, contributing to understanding genetic factors in stroke pathology.

Results

The study revealed a high incidence of thrombophilia-related gene abnormalities, with 77.7% of cases exhibiting two or more heterozygous or homozygous abnormalities. The most prevalent gene results found was MTHFR C677T with 26 heterozygous state (57.8 %) and 4 homozygous state (8.9 %) followed by MTHFR A1298C with 17 heterozygous state (37.8 %) and 4 homozygous state (8.9 %) followed by B-Fibrinogen -455 G∼A with 17 heterozygous state (37.8%). The majority of patients had mild stroke severity. Genes PAI-1 a/b, APO B R3500Q, APO E genotype was negative in all cases. These findings underscore the importance of considering thrombophilia in stroke etiology and emphasize the need for further research to elucidate its clinical implications for improved patient management and prognosis.

Conclusion

This study underscores thrombophilia's relevance in ischemic stroke of undetermined aetiology. And reveals the high incidence of some genes while rare incidence of others, emphasizing the need for further research.
Relation of Serum Alpha 2-Antiplasmin to Clinical Response to Intravenous Recombinant Tissue Plasminogen Activator in Acute Ischemic Strokes without Large Vessel Occlusion
Authors: Mikhail Narges Wagih , El-Khawas Hala M , Tork Mohamed A , Abdel Rady Metawaa Maha Ahmed , Mahmoud Kenawy Fatma Fathalla
Published: November 2024

Background

Stroke is ranked as the second leading cause of death worldwide with an annual mortality rate of about 5.5 million. Not only does the burden of stroke lie in the high mortality but also the high morbidity. Recent studies revealed that up to 50% of survivors being chronically disabled in 2022. Thrombolysis has limited efficacy in the presence of large volume clots, thrombus ultrastructure, hemorrhagic transformation, high National Institutes Of Health Stroke Scale (NIHSS) prior to rtPA and thrombolysis resistance due to the presence of plasminogen activator inhibitor-1(PAI-1) and alpha 2-antiplasmin. Plasminogen is converted to plasmin by plasminogen activator and plasminogen activator can be inhibited by plasminogen activator inhibitors 1 and 2. On the other hand, plasmin itself is directly inhibited by alpha 2- antiplasmin, an ultrafast covalent inhibitor, which accounts for about 90% of plasmin inhibition in vivo and antagonizes the action of rtPA which consequently prolong clot lysis.

Aim of the Work

To identify the relationship between serum alpha 2-antiplasmin, various risk factors and clinical response to recombinant tissue plasminogen activator in ischemic cerebrovascular stroke.

Patients and Methods

This is prospective cohort study was conducted at Ain Shams University Hospitals on acute ischemic stroke patients who received thrombolysis, met the inclusion and exclusion criteria. A blood sample to measure serum alpha 2-antiplasmin was obtained before receiving thrombolysis and patients were followed up for 3 months.

Results

A study on 35 patients showed that there is significant correlation between atrial fibrillation and poor functional outcome in stroke patients who received thrombolysis with p- value=0.033. Also, it shows there is significant correlation between hypertriglyceridemia and poor outcome with p-value= 0.043. It also shows there is a significant correlation between serum alpha 2-antiplasmin level and resistance to thrombolysis with subsequent poor functional outcome with a cut-off point 493 ng /L with a sensitivity 100% and a specificity 81.8% (p-value=0.001).

Conclusion

This study shows that alpha 2-antiplasmin levels are correlated with cerebrovascular stroke outcome, high levels are associated with poor functional outcome and resistance to IV thrombolysis. Therefore, its inhibition may be crucial to improve the clinical outcome of stroke in the future.
Clinical Evaluation of Multiple Sclerosis Patients during Pregnancy Period in a Sample of Egyptian Patients
Authors: Asaad Reem Tarek , Fouad Mohamed Mahmoud , El Hafeez Mohamed Aly Abd , Eldin Nouran Mohamed Salah
Published: November 2024

Background

Multiple sclerosis is a complex, autoimmune mediated disease of the central nervous system, characterized by inflammatory demyelination and axonal / neuronal damage. There is increasing incidence and prevalence of MS in both developed and developing countries, the underlying cause of which remains uncertain. MS is a complex disease; many genes modestly increase disease susceptibility in addition to several well defined environmental factors, in particular vit D or ultraviolet B light (UVB) exposure, Epstein-Barr virus (EBV) infection, obesity and smoking. Multiple sclerosis (MS) is three times more likely to be seen in women and usually diagnosed between the ages of 20-50 years.

Aim of the Work

To Study effect of MS and DMDs on pregnancy outcome (natal & postnatal period) and during breast feeding and to study effect of pregnancy on MS regarding relapse rate and disability progression.

Patients and Methods

This study is an Observational analytical retrospective study, conducted at multiple sclerosis clinic of neurology department at Ain Shams University Hospitals. Patients will be collected retrospectively from June 2018 till June 2022. We will collect 60 female patients diagnosed with multiple sclerosis according to McDonald criteria within the childbearing period.

Results

We observed that multiple sclerosis has no adverse effect on fertility or gravidity. Also, we observed that there is increase in relapse rate within the postpartum period which is associated with increase in EDSS score compared to that before pregnancy. The early use of DMD before conception has protective effect and delay progression on the other hand, the use of DMD was associated with increased maternal and fetal complications especially low birth weight and preterm delivery.

Conclusion

Pregnancy is associated with increased relapse rate especially during postpartum period but the early use of DMD before conception is protective against occurrence of relapses and delay onset of progression with no fatal adverse events on the mother or the fetus.
Mental Health Impact of Covid-19 on Healthcare Workers in Relation to Their Personality and Coping Mechanism
Authors: El Bayoumy Safaa Ragab , Elsheikh Mona Mahmoud , Elserafi Doha Mostafa , Elsehrawy Tarek Mohamed
Published: November 2024

Background

COVID-19 pandemic was a worldwide health threat, health care workers were subjected to severe degrees of mental, physical and psychological stress especially those working in quarantine hospitals.

Aim of the Study

The aim of the present study is to evaluate frequency of mental health problems among Health Care Workers (HCWs) (who work in quarantine hospitals during COVID-19 pandemic) in relation to their personality and coping mechanism.

Patients and Methods

This study included 200 HCWs in quarantine hospitals, including Physicians and Nurses of both genders and between the age of 20-40. Each of the participants were assessed using Covid Stress Scale, Beck's Depression Inventory Scale, Taylor Manifest Anxiety Scale, Eysenk Personality Questionnaire, Brief Coping Scale.

Results

Depression among HCWs was moderate in 19% and severe in 18% of subjects. There was a significant positive correlation between anxiety, depression and COVID stress. Assessing personality traits revealed psychoticism in 26% of the sample, neuroticism was found in almost 25%, 7.1% were extroverts and they were females, impulsivity/criminality traits were found in 62% of our sample, 8% of the sample were detected having high lying score in lie sub scale and all of them were females. Regarding coping mechanism, the emotion focused coping and the problem focused coping mechanisms were predominant.
Clinical and Sociodemographic Characteristics of Depressive Symptoms in a Sample of Egyptian Patients with Schizophrenia
Authors: Okasha Tarek Ahmed , Hamed Marwa Abdelmeguid , Naguib Rehab Mohamed , Dessouki Nahla Abdel Rahim , Mahmoud Sara Mohiey Mohammad
Published: November 2024

Background

Schizophrenia is a major psychiatric illness across the world, severely affecting the quality of life, and could be commonly associated with depressive symptoms, although its underlying pathology is still unclear and recently multiple studies were concerned with the relation between Schizophrenia and depressive symptoms.

Objective

To determine the rate of occurrence of depression in patients with Schizophrenia & assess the relation between the sociodemographic and clinical characteristics of patients with Schizophrenia with depressive symptomatology.

Patients and Methods

This was an analytical cross-sectional study; carried out at Okasha Institute of Psychiatry, between September 2023 to March 2024.

Results

There was no statistically significant difference found between patients with and without depression, as confirmed or excluded by the CDSS, regarding PANSS and SANS scores. There was no statistically significant correlation between depressive symptoms in patients with Schizophrenia and the mentioned sociodemographic and clinical characteristics except for male gender as a protective independent factor and duration of illness ≥ 8 years as an independent risk factor. Further investigations via longitudinal studies and on larger samples are recommended to settle specific causal paths between the two variables.

Conclusion

Our study revealed that the male gender is a protective independent factor for depression in patients with schizophrenia and that the duration of illness ≥ 8 years is an independent risk factor for depression in schizophrenia. Yet, there are no other statistically significant sociodemographic or clinical characteristics associated with depressive symptoms in patients with Schizophrenia.
Comorbidity of Eating Disorder in Patients with Bipolar Mood Disorder Type I and Type II in Euthymic State, Case Control Study
Authors: Okasha Tarek Ahmed , Hamed Marwa Abd El Meguid , Khalil Sherien Ahmed , Sehrawy Tarek Mohamed El , AbdAllah Sarah BahaaElDin
Published: November 2024

Background

Bipolar mood disorder it is one of the leading causes of disability worldwide. Bipolar disorders are furtherly classified as bipolar I disorder, bipolar II disorder, cyclothymia and other categories of atypical forms that do not fulfill the criteria for the abovementioned subtypes. There is growing recognition of the clinical significance of eating disorder (ED) comorbidity in patients with bipolar disorder (BD). The prevalence rate of EDs in BD vary substantially according to the studies in recent years.

Patients and Methods

This study is a case control study, the study conducted at psychiatric outpatient clinic in Ain Shams University Hospitals, starting from June 2022 till completion of the sample.

Results

This study shows that there is correlation between eating disorders and bipolar mood disorders where there was statistically significant difference on applying the eating disorder inventory (EDI) on both cases and controls with the cases having higher scores on the EDI total scores and severity. The study revealed the potential role of different risk factors on both eating disorders and bipolar mood disorder.

Conclusion

It is one of the preliminary studies done in Egypt aiming to investigate the correlation between eating disorders and bipolar mood disorders and that Screening for all individuals having bipolar mood disorders underlying eating disorders is essential for proper intervention and management.
Coping Strategies and Burden Stress in Caregivers of Patients with Schizophrenia and Patients with Bipolar Disorder
Authors: Mohamed Rehab Serag , Mahmoud Nivert Zaki , Mahmoud Dalia Abdel Moneim , Eissa Mohamed Fekry , Zohdy Youssef Wael , Rateb Hafez Yassmin Shawky
Published: November 2024

Background

Mental illness has a great impact not only on patients but also on their caregivers as it makes them more prone to stress, interferes with their daily life activities and can negatively affects their social, psychological and physical health quality of life. They neglect seeking medical help that may negatively affect clinical outcome of patients and quality of their life. Therefore, it is important to evaluate the magnitude of burden on such caregivers and to investigate the coping strategies used by them in order to develop tailored bio psychosocial interventions to reduce their stress.

Objective

To assess the magnitude of burden and patterns of coping with stress in caregivers of patients with schizophrenia. To assess the magnitude of burden and patterns of coping with stress in caregivers of patients with bipolar affective disorder. To compare both the coping strategies and burden stress scores among caregivers of patients diagnosed with schizophrenia and bipolar patients.

Patients and Methods

This cross sectional study was done on 100 caregivers to assess burden in caregivers of schizophrenia patients and caregivers of bipolar patients, the coping style used by the caregivers of both groups and comparing between two groups.

Results

There was statistically significant difference found between bipolar group and schizophrenia group regarding coping inventory scores make fun and behavioral withdrawal, which showed higher median score in schizophrenia group than bipolar group. Burden of caring and coping with this burden, affect each other mutually. As, according to the results of our study, rural residence of caregiver, positive reassessment ≤12 and denial >8 were found significantly associated with high burden in bipolar group. While employed caregivers were associated with high burden among schizophrenia group. Burden is higher in bipolar group than schizophrenia group.

Conclusion

Appraisal by, and burden on caregivers play a major role in determining their style of coping. These factors largely accounted for the differences in coping observed between caregivers of patients of bipolar disorder and schizophrenia, in this study. Reducing burden on caregivers and enhancing their awareness of illness could lead to adoption of more adaptive coping styles by them.
Planned Outpatient Care versus Hospital Admission for Women with Preterm Prelabor Rupture of the Membranes (PPROM): A Randomized-Controlled Clinical Trial
Authors: Abdelmageed Abdelmageed Ismail , Riad Amr Ahmed Mahmoud , El-DinMansor Ahmed Mohamed Essam , Yehia El-Kholy Ahmed Khaled Ahmed
Published: November 2024

Background

Preterm premature rupture of membranes (PPROM) is a condition where the amniotic sac ruptures before the onset of labor, occurring in about 3% of pregnancies. It is a leading cause of perinatal morbidity and mortality, resulting in neonatal morbidities such as respiratory distress syndrome, necrotising enterocolitis, and sepsis. Depending on the gestational age, complications such as chorioamnionitis, premature placental abruption, umbilical cord prolapse, and postpartum infections can occur. The clinical course following PPROM depends on the latency period, which is inversely correlated with gestational age and influenced by several factors, including the presence of antepartum hemorrhage and cervical opening.

Objective

To examine the efficacy and safety of planned outpatient management versus hospital admission for women with preterm prelabor rupture of the membranes (PPROM) in terms of fetal, neonatal, and mother outcomes.

Patients and Methods

patients were divided into two groups (O) was planned for outpatient care and Group (H) was hospitalized after randomization. The primary outcome was comparing between two groups regarding the latency period and other maternal and neonatal outcomes were recorded.

Results

Regarding the results of our study, we found that there is no statistically significant difference between the study groups regarding age and parity. No statistically significant difference between the study groups regarding gestational age at enrollment and delivery as well as well as the latency period between them being slightly longer in the outpatient group. As regards the neonatal outcome, the rate of complications was insignificant among both groups, Intra-amniotic infection being slightly higher among hospitalized group, antenatal fetal distress & post-natal fetal respiratory distress syndrome as well.

Conclusion

PPROM is a serious condition that can result in neonatal morbidities and maternal complications. Expectant management is usually implemented, with hospitalization being the conventional policy recommended until delivery. However, outpatient care may offer a safe and low-cost alternative with a relatively longer latency period. Further studies are needed to confirm the safety of outpatient care in PPROM patients and to address the concerns about potential obstetric emergencies.
Association of Intra-Abdominal Adhesions with Ultrasonographic Sliding Sign in Third Trimester Women Prior to a Repeated Cesarean Section
Authors: Farid Mohamed Kassem Ahmed Mohamed , Ismail Abdel-Megeed Abdel-Megeed , Abdelnasser Ahmed Gamal , Mahmoud Riad Amr Ahmed
Published: November 2024

Background

Adhesions are the most frequent complication following abdominal and pelvic surgery, developing after more than 90% of interventions concerning the abdominal cavity. Consequences include infertility, chronic pelvic pain and small bowel obstruction. Adhesions increase the complexity of future surgery by increasing the risk of urinary tract and intestinal injury, and by increasing the operative duration and thus the risk of blood loss.

Objective

To evaluate the efficiency of preoperative transabdominal ultrasonographic features in prediction of intra-abdominal adhesions in pregnant women during third-trimester with history of previous cesarean section surgery scheduled for a planned repeated elective C.S. delivery.

Methods

After ethical committee approval and informed consent from the patients, this prospective study was performed on total 200 third-trimesteric pregnant women with history of previous cesarean section who admitted for elective caesarian section and willing to participate in the study to investigate the value of the sonographic evaluation in predicting the intra-abdominal adhesions at tertiary care hospital at Ain Shams University Maternity Hospital from January 2023 till October 2023 and performed on total 200 patients who underwent elective caesarean delivery.

Results

The findings of our study demonstrated a good capability of a simple third-trimester transabdominal sonographic sign, the absence of sliding of the uterus, to predict the presence of intra-abdominal adhesions in women undergoing repeat CS.

Conclusion

We concluded that the real-time dynamic transabdominal ultrasound sliding sign is a non-invasive, well-tolerated technique. Its preoperative analysis in patients who have had previous abdominopelvic surgery may help to evaluate the risk of bowel or bladder injury and the complexity of the planned intervention, improving the safety of surgery, and may help to inform the anesthesiologist regarding the expected duration of the intervention and any potential complications during the procedure.
Laminiria Tents versus Vaginal Prostaglandin in Cervical Ripening in Term Induction of Labor with Unfavorable Cervix: A Randomized Controlled Trial
Authors: Mohamed Ahmed Mohsen Hassan , Abou El Nour Ayman Abdul Razek , El Sabaa Haitham AbdelMohsen , Abdelrazek Maya Mahmoud
Published: November 2024

Background

Mechanical methods used for induction of labor received a great attention nowadays due to the serious side effects of the pharmacological methods. Hygroscopic dilators are considered important subtype of these mechanical methods. One of them is Laminaria which is a synthetic type of sea algae that induces cervical dilation by absorbing water from the cervix and gradually increasing in thickness.

Objective

To compare the effectiveness and safety of Laminiria tents to intravaginal prostaglandins for cervical ripening in induction of labor at term gestation in women with unfavorable cervix.

Methods

A total of 90 pregnant women at term gestation with unfavorable cervix admitted to the labor ward for induction of labor at Ain Shams University Maternity Hospital, in the period from March 2022 to March 2023, were enrolled in the study and underwent assessment using Bishop score with monitoring differences between two groups in mode of delivery, time to enter active phase, time to delivery, changes in bishop score and noted complications. This study was registered on clinicaltrials.gov with number (NCT06151925)

Results

In the present study we demonstrated that in laminaria group, there was 66.7% had NVD and 33.3% had CS while in prostaglandin group, there was 71.1% had NVD and 28.9% had CS in which there was no statistically significant difference between laminaria and prostaglandin groups regarding routes of delivery. In this study we demonstrated that Time needed to enter active phase (hours) in laminaria group was 16 (10 – 19) while in prostaglandin group was12 (8 – 16) in which there was a statistically significant difference between laminaria and prostaglandin groups regarding Time needed to enter active phase (hours) (p = 0.022). In this study we demonstrated that regarding induction delivery time (hours) in laminaria group was 20 (13 – 25) while in prostaglandin group was 16 (11 – 20) in which there was a statistically significant difference between laminaria and prostaglandin groups regarding induction delivery time (hours) (P = 0.036).

Conclusion

Vaginal prostaglandin is more effective than laminaria tent for ripening of cervix before induction and can decrease labor duration and time to delivery. However, for better results further studies with a larger sample size are recommended.
The Outcomes of Second Trimesteric Induction of Abortion in Previously Scarred Uterus at Ain Shams Maternity Hospital
Authors: El guindy Alaa Eldin Abdel-Aziz , Mohyi Eldin Maii Medhat Nawara , Taha Felfela Taha Samir
Published: November 2024

Back Ground

Termination of pregnancy by induced abortion is one of the commonest procedures, Pregnancy termination in case with prior cesarean delivery becomes an increasingly common situation facing obstetricians due to progressive increase in the rate and incidence of cesarean births.

The aim of the Study

was to assess and evaluate the outcomes of second trimesteric induction of abortion in previously scarred uterus.

Methods

this was a retrospective study curried at Ain Shams Maternity Hospital at the period from the 1st of January 2018 till the 31st of December 2020.

Results

Patients subjected to hysterotomy received significantly higher dosed of misoprostol compared with those who did not undergo hysterotomy (median [IQR] = 1100 [800 – 2400] mg versus 800 [500 – 1600] mg, respectively; p= .047).

Conclusion

There were 15.5% suffered failed medical abortion and 1.5% rupture uterus with difficulty to correlate this event to the dose of the medication used for induction. Increased gestational age, history of 3 or more CS, and presence of > 1 gestational sac was independently associated with decreased probability of successful medical abortion. Higher total dose of misoprostol was only marginally associated with decreased probability of success. On the other hand, higher hemoglobin level is independent predictor of successful medical abortion. Patients subjected to hysterotomy received significantly higher dosed of misoprostol compared with those who did not undergo hysterotomy.
Survival Benefit from Total Neo-Adjuvant Therapy in Locally Advanced Rectal Cancer Patients
Authors: Azmy Aly Mohamed , Mosalem Nesreen Ahmed Elsayed , Mostafa Mohamed Yassin , Saleh Mohammed Essam , Ahmed Hager Reda Mohammed
Published: November 2024

Background

Preoperative chemoradiation in patients with locally advanced rectal cancer has no impact on overall survival (OS) and distant recurrences. The aim of the study was to evaluate local downstaging, toxicity, patient compliance and long-term outcome (2 year OS and DFS) in patients with locally advanced rectal cancer after induction chemotherapy with 12 weeks of 5 fluorouracil based chemotherapy followed by radiotherapy concomitant with capecitabine before total mesorectal excision (TME).

Patients and Methods

Between January 2018, and December 2019, we enrolled eligible patients with poor-risk rectal cancer defined by high-resolution MRI (Any cT3 and T4 stage, T2 low lying tumor at or below the levators and node positive tumor) and without metastatic disease Patients were planned for 12 weeks of neoadjuvant capecitabine and oxaliplatin (oxaliplatin 130 mg/m² on day 1 with capecitabine 1000 mg/m² twice daily for 14 days every 3 weeks) followed by chemoradiotherapy (50.4 Gy in a conventional fractionation) with capecitabine (825 mg/m² twice daily), then total mesorectal excision (TME) was carried out 6 weeks after the completion of CRT.

Results

Of 70 consecutively admitted patients starting induction chemotherapy, 55 patients underwent surgery. R0 resection was seen in 92.7% and pathological downstaging in 72.7%. In the intention-to-treat group, Objective response rates after neoadjuvant chemotherapy and chemoradiotherapy were 51.4% and 48.6%, respectively. Pathological complete response was seen in 15.7 %. Two-year disease-free survival (DFS) and OS were 62.5% and 82.6%, respectively. Grade 3/4 toxicity was seen in 20 %, and only one case died within 2 months of therapy.

Conclusion

Intensification of systemic therapy with neoadjuvant combination chemotherapy before standard treatment is feasible in poor-risk potentially operable rectal cancer, with acceptable safety and promising long-term outcomes. Future development of this multidisciplinary treatment strategy in randomized trials is warranted.
Comparative Study between Acute Side Effects in Patients Treated with Brachytherapy versus External Beam Radiotherapy in Early Stage Endometrial Cancer
Authors: Mohamed Elgabalawy Manar Adel Abd El Monaem , Mohamed Ehab Moustafa , Adel Azza Mohamed , Qady Mohamed Sabry Al , Meckawy Ghada Refaat , Mohamed Sara Essam
Published: November 2024

Background

Adenocarcinoma of the endometrium is the most common malignancy of the female genital tract. The main line of treatment of early stage endometrial cancer is total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adjuvant radiotherapy either external beam radiotherapy or vaginal brachytherapy.

Aim of the Work

To compare acute toxicities between patients who received adjuvant high-dose- rate (HDR) vaginal brachytherapy (VBT) and those who received external beam radiotherapy (EBRT) in early stage endometrial cancer.

Patients and Methods

This is a retrospective study was conducted on 62 patients with histologically proven endometrial carcinoma at the Clinical Oncology Department, Ain Shams University Hospitals, Cairo, Egypt for 6 months from January 2020 to December 2022.

Results

The results of this study showed that different side effects were less frequent in HDR VBT group than in EBRT group, the differences were statistically significant only in nausea, diarrhea, bleeding per rectum, dysuria, abdominal pain, bony aches and skin toxicity. Among cases with acute side effects, grades of side effects were lower in HDR VBT group than in EBRT group, but the differences were statistically non-significant.

Conclusion

HDR-VBT may be a less toxic option than EBRT for the adjuvant treatment of early stage endometrial cancer. However, more research is needed to confirm these findings and to better understand the long-term risks and benefits of each treatment option.
Efficacy and Safety of SARS-COV-2 Vaccines in Breast Cancer Patients
Authors: Canaan Mira Youssef Robert , Abdulla Hatem Mohamed , Al-Kady Mohamed Sabry , Gomaa Nada Ezzeldin , Mohammed Fahim Noha Alaa El-Din , Sherif Diaa Eldin Moussa
Published: November 2024

Background

Breast cancer (BC) is a major public health problem. COVID-19 pandemic impacted all areas of daily life, including medical care. In particular, delivering care for patients with cancer or suspected cancer during the crisis was challenging given the competing risks of death from untreated cancer versus serious complications from SARS- CoV-2, and the likely higher lethality of COVID-19 in immunocompromised patients.

Aim of the Work

This study aims to assess the efficacy and immunogenicity of SARS COV 2 vaccines in breast cancer patients by evaluating anti spike antibodies in vaccinated and non vaccinated patients and also through assessing the infection with covid after vaccination (in vaccinated patients) and in non vaccinated patients. The study also aims to assess the Safety of SARS COV 2 vaccine in breast Cancer patients (local and systemic Toxicity).

Patients and Methods

Our population consisted of 120 female patients diagnosed with early and locally advanced breast cancer, in the breast cancer unit, Clinical oncology department, Ain Shams University Hospitals. All on systemic therapy (on neoadjuvant or adjuvant treatment). Sixty vaccinated and 60 unvaccinated against COVID-19. The cutoff value of SARS COV-2 antibody is 50 BAL/mL (>/= 50 seropositive, <50 seronegative)

Results

Out of 120 patients, Anti-SARS COV-2 Antibody seropositivity was found to be 48 vs. 58 pts (80% vs. 96.7%) in non vaccinated Vs. Vaccinated patients, with a P-value=0.0046), which was statistically significant. The median titre in both groups was found to be 1434.5 vs. 2500, (P = 0.0026). In the 120 patients, 26 patients had covid infection with a significant difference, Non vaccinated Vs. Vaccinated: 21 vs. 5 pts (35% vs. 8.3 %, P = 0.0004). In the sixty vaccinated patients, mild local adverse events were reported such as warmness at site of injection in 17 patients, representing (28.3%) of patients, Pain 11 (18.3%), Swelling 11 (18.3%), Itch 8 (13.3%), and Redness 6 (60%) representing the least adverse event. The patients experienced mild systemic adverse events, the highest incidence was Fatigue 28 (46.7%), then Myalgia/arthralgia 17(28.3%), headache 2 (3.3%),and fever 16 (26.7%).

Conclusion

Anti SARS COV2 are effective and safe in localized breast cancer patients on systemic therapy.
Correlation between Clinicopathological Features of Soft Tissue Sarcoma and Clinical Outcomes; A Retrospective Study
Authors: Elsayed Noha Mohamed Elsayed , Riad Atef Youssef , Gaballah Ahmed Mohamed , Nofal Ahmed Maamoun , Hussein Mariam Mohamed , kelany Mohamed Reda
Published: November 2024

Background

Sarcoma is a rare and diverse mesenchymal cancer that accounts for fewer than 1% of all adult cancers and 10% of paediatric tumours. Around 11,000 new cases are diagnosed each year in the United States, accounting for <1% of all cancers. Approximately 80% of sarcoma originate from soft tissue, and the rest originate from bone. Most sarcomas (about 55%) affect mainly the extremities, mostly the legs, and about 15% affect the head and neck area or trunk, the rest are retroperitoneal or intraperitoneal.

Objective

The primary objective is to determine the clinicopathological features and treatment strategies of soft tissue sarcoma and its correlation to clinical outcomes in the form of Overall survival, Disease free survival and Progression free survival in the period from January 2017 to December 2021.

Methods

This study is a retrospective study that included 151 patients diagnosed with soft tissue sarcoma attending the sarcoma unit at the Clinical Oncology Department, Ain Shams University, in the period between the start of January 2017 to the end of December 2021

Results

151 patients were eligible for overall survival evaluation in which median OS was 80 months. Disease free survival was calculated in 133 patients in our study with median DFS 36 months. Patients presented with metastasis from the start represented 10.5% of the population. Meanwhile 23% of the studied population developed metastasis later on, with median PFS 17 months. The most common site of metastasis was lung in 36.5%. Metastasis at initial presentation had a negative impact on overall survival with p value < 0.001. Resection margin had high impact on overall survival outcomes and recurrence with p value <0.001 and <0.018, respectively. Other clinicopathological factors that had a statistical significance on OS and DFS and local recurrence were; Age, ECOG, tumor size, stage and resection margin.

Conclusion

STS represents a heterogenous group of malignancies that require multidisciplinary team and referral to experienced tertiary centers. Treatment patterns for STS have evolved with increased utilization of neoadjuvant radiation therapy for patients diagnosed with resectable disease aiming for less toxicity with lower dose and smaller treatment volume, limb sparing surgery with free resection margins and better quality of life. We concluded that the most significant predictors of survival and prognostic factors are; stage at initial presentation, type of surgery and margin status.
Correlation between Molecular Subtype and Clinicopathological Characteristic in Breast Cancer Patients Retrospective Study
Authors: Elshamely Shaimaa Hamdy Faried , Sayed Ismaael Souhair , Tawfik Amr Shafik , Meckawy Ghada Refaat , Faheim Reham Mohamed , Hakem Sherif Hassanien Ahmed
Published: November 2024

Background

Breast cancer is the most common malignancy in women and the fifth cause of cancer mortality worldwide. Breast cancer is a heterogeneous disease characterized by a wide spectrum of many subtypes with distinct biological features that lead to differences in clinicopathological presentation.

Aim of the Work

To correlate clinicopathological characteristics and molecular subtypes and estimate the distribution of breast cancer (BC) subtypes and characteristics.

Patients and Methods

This is a retrospective study that was conducted on 1413 female patients diagnosed with breast cancer in the Clinical Oncology department, at Ain Shams University Hospital from January 2018 to December 2020 to study the correlation between clinicopathological staging and molecular subtype.

Results

The study found that luminal A and luminal B HER2-negative were the most common molecular subtypes of breast cancer in the studied population, and there was a significant association between post-menopausal status and these subtypes. There was a significant association between clinical/pathological staging and different molecular subtypes. Patients with higher age or Ki67 > 14% were more likely to have higher stages of breast cancer.

Conclusion

Molecular subtype of breast carcinoma should routinely be done for all cases of carcinoma breast. They provide valuable information not only about response to therapy but also about possible clinical outcome.