bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Study between 3D Echocardiography Right Ventricular -Volumes and Functions- and Invasive RV Quantification in children with valvular pulmonary stenosis pre and post balloon Dilation
Authors: Hafez M , Kamel H , Abdelrazik Y , Attia H
Published: October 2021

Aim and objectives

The aim of this study was To correlate between 3D echocardiographic assessment of RV volumes and functions with invasive RV quantification by angiography in children with mainly valvular pulmonary stenosis undergoing balloon pulmonary valvuloplasty pre & post balloon dilation, to evaluate the immediate impact of relieving obstruction on RV volumes.

Patients and Methods

The study included 25 patients in the pediatric age group (up to 18 years old) with Pulmonary valve stenosis referred to our congenital and structural heart disease unit cardiology department in Ain shams university hospital for balloon pulmonary valvuloplasty. All patients were subjected to history taking, clinical examination and ECG recording. Then echocardiographic assessment by 2D and 3D was done to all patients pre and post BPV. All patients were subjected to have pre and post RV angiography for assessment of RV volumes and functions angiographically.

Results

The study included 25 patients,65% of patients were males and 44% were females, mean of age was 22.79 with range from 2 to 144 months There was statistically significant increase in 3D Echo RV quantification post BPV in comparison to 3D Echo RV quantification pre BPV with RV/EDV(p-value:0.001), RV/ESV(p-value:0.034), RV/SV(p-value:0.002), FAC %(p-value:0.014), TAPSE(p-value:0.001). Also,there was statistically significant increase in angiographic RV quantification post BPV in comparison to angiographic RV quantification pre BPV with EDV(p-value:<0.001), ESV(p-value:<0.001), SV(pvalue:<0.001) and EF %(p-value:<0.001).

Conclusion

3DE RV volumes and function shows good correlation and agreement with invasive RV quantification by angiography in children with valvular pulmonary stenosis undergoing balloon pulmonary valvuloplasty.
Serum Leptin In Ischemic Heart Disease Patients With And Without Significant Diastolic Dysfunction In Lean And Obese Patients; Cross Sectional Study
Authors: Hamed Ola Mohamed Saad , Tamara Ahmed Fathy , Arab Tamer Abu , Zahran Mohamed
Published: October 2021

Background

Cardiovascular diseases represent the leading cause of mortality worldwide. Ischemic heart disease is one of the main causes of diastolic heart failure and its presence predicts a poor prognosis in ischemic heart patients. Most cardiovascular diseases can be prevented by addressing behavioral risk factors such as overweight and obesity. Leptin –also known as satiety hormone- helps in inhibiting hunger and regulate energy balance (1).

Objective

to correlate leptin level with ischemic heart disease with or without diastolic dysfunction by comparing it in lean and obese patients.

Material and Methods

from June 2019 to November 2019, 140 ischemic patients documented with CA, MSCT or history of PCI AND 35 Control subjects were enrolled from both Ain Shams University, Cardiology department wards and outpatient clinic and Misr University for science and technology, cardiology department wards and outpatient clinic. All participants subjected to history, clinical examination, Duke CAD index to estimate the severity of ischemia, calculation of their BMI, blood sampling for measuring their serum leptin level and echocardiography for detecting the diastolic function. Patients were divided into four groups according to their BMI and Diastolic function in addition to the control group. Groups were demonstrated as follow Group A lean ischemic patients without significant diastolic dysfunction, Group B lean ischemic patients with diastolic dysfunction (II-IV), Group C obese ischemic patients without significant diastolic dysfunction, Group D obese ischemic patients with diastolic dysfunction(II-IV), Group E is a control group lean non ischemic without diastolic dysfunction .

Results

There were significant positive correlations between serum leptin and Duke score in all ischemic groups (n = 140) (p < 0.001). Serum leptin abnormality was significantly more frequent in diastolic dysfunction groups (n = 70) than in non-dysfunction groups (N = 70) (Group B 25.7%, group D 28.6% vs group A 5.7% group C 8.6%, also was lowest in control group (n = 35) 0.0%. serum leptin was significantly positive correlated with ischemia as in group A17.8±2.1ng/mL group B 23.4±11.1ng/mL group C 55.4±10.9 ng/mL group D 65.2±10.8 ng/mL vs control group E 13.1±2.7 ng/mL.

Conclusion

leptin is an independent risk factor for coronary heart disease. Also elevated plasma leptin levels are associated with impaired left ventricular diastolic function in patients with CAD independently of obesity and other confounding variables.
Role of Colchicine in Prevention of Contrast Induced Nephropathy in Patient Undergoing Primary Percutaneous Coronary Intervention
Authors: Elhodhod Omar M , Farouk Mohamed M , Khorshed Walid A Hazem M , Hammady . El
Published: October 2021

Background

Contrast-induced nephropathy (CIN) is a frequent complication after intravascular contrast media administration. The incidence of CIN in STEMI patients undergoing primary PCI is around 19.8%. The pathophysiologic basis of CIN includes an oxidative stress and inflammatory process, and colchicine has been used as an anti-inflammatory and anti-oxidant agent to improve cardiovascular outcomes, hence the aim of the current study is to demonstrate the effect of colchicine on CIN in patients undergoing primary PCI.

Patients and methods

100 STEMI patients planned for primary PCI were enrolled in this study. They were randomized into two groups of fifty patients: A control group receiving standard guideline based medical treatment alone and a study group receiving same treatment in addition to colchicine. CIN was defined based on serum creatinine that was measured repeatedly over 3 days, with absolute rise of 0.5mg/dl or relative rise of 25% or more from baseline signifying CIN.

Results

There was a trend towards lower CIN incidence, although not statistically significant, in patients receiving colchicine, in whom CIN incidence was 8%, in comparison to incidence of 20 in those receiving standard guideline-based therapy alone % (χ2 = 2.99 & p = 0.083) with relative risk reduction of 60%. The reduction of CIN incidence was found to be statistically significant in diabetic subgroup, with CIN incidence of 32% in those receiving standard guideline-based therapy alone, in comparison to incidence of 7% in those receiving colchicine with p = 0.033. Multiple regression analysis including colchicine as a covariable concluded that colchicine use was the most important CIN risk lowering factor in the current study (β = -0.223 and p = 0.039).

Conclusion

There was a trend towards lower incidence of CIN in patients undergoing primary PCI receiving colchicine, although not statistically significant. However, this trend became significant when studied in diabetic subgroup.
Assessment of Longitudinal Left Ventricular Function in Patients with Coronary Artery Ectasia by 2D Speckle Tracking Echocardiography
Authors: sayed Radwa Gad EL , Abdelmonaem Mustafa , William Viola , Adel Walaa
Published: October 2021

Background

Coronary artery ectasia (CAE) is one of the uncommon cardiovascular disorders. CAE is one of the known risk factors for acute coronary syndrome, its incidence ranges from 1.5%-5% of patients undergoing coronary angiography, with predominance in males. Coronary artery ectasia (CAE) is defined as dilatation of an arterial segment to a diameter at least 1.5 times that of an adjacent normal artery and involves at least one third of the affected artery (1)(1). The exact pathogenesis of CAE is not well established; however, Coronary atherosclerosis is detected in more than 50% of the patients.

Objective

To evaluate global left ventricle longitudinal strain by 2D speckle tracking echocardiography in patients with coronary artery ectasia and without significant (>50%) coronary artery stenosis.

Patients and Methods

This study carried on sixty patients referred to cath lab of Ain Shams university hospital for elective coronary angiography during period between January 2018 and Augest 2019. The patients were divided in to two groups (Group A) included thirty patients with ectasia in one or more of the coronary arteries without any significant coronary artery stenosis and (Group B) included thirty patients with normal coronary angiographic findings serving as control group.

Results

The present study showed a statistically significant decrease in EF comparing CAE group to control group .As regards other echocardiography parameters, there was a highly significant difference of LVEDD, LVEDD index, LVESD,, LVESD index, LV mass, LV mass index, LA volume and LA volume index between the two groups. Global peak longitudinal strain showed highly significant difference between two groups as its mean value was significantly lower in the CAE group.

Conclusion

In our study, we have concluded that global peak longitudinal strain was significantly impaired in patients with coronary artery ectasia without significant coronary artery lesion denoting subclinical LV systolic dysfunction .LV diastolic dysfunction was more prevalent in coronary artery ectasia patients compared to control subjects.
Diagnostic Utility of Red Blood Cell Indices-Derived Formulas in Discriminating Beta-Thalassemia Trait from Iron Deficiency Anemia
Authors: Shoukry Maggie Ibrahim , Osman Amany Ahmed , Eissa Deena Samir
Published: October 2021

Background

The two most frequently encountered microcytic hypochromic anemias are iron deficiency anemia (IDA) and β-thalassemia trait (β-TT) which need relatively expensive laboratory tests to be differentiated.

Objectives

This study aims at evaluating the diagnostic utility of different discrimination formulas derived from red blood cell indices from complete blood count in the differentiation of β-TT from IDA.

Subjects and Methods

This study was conducted on 140 subjects; 40 healthy individuals and 100 patients (60 IDA and 40 β-TT) recruited from outpatient clinics of Ain Shams University Hospitals. They were 45 males and 95 females (M: F 1:2.1), their ages ranged from 19 to 63 years. Patients were subjected to measurement of CBC, iron profile, Hb electrophoresis and HPLC and calculation of RBC indices- derived formulas.

Results

Comparative studies of different formulas among the studied group shows that England and Fraser (E & F), MDHL, MCHD, MCI and Zaghloul 2 can significantly differentiate between β-TT patients and IDA patients (P was 0.009, 0.008, 0, 0.001 and 0.050 respectively). Evaluation of diagnostic performance (efficacy) of the studied RBCs formulas showed that Zaghloul 2 is the best index in discriminating β-TT from IDA at cut off 66.61 with specificity (97.5%), sensitivity (76.7%) and diagnostic efficacy (85%). This was followed by MCI at cut off 22.73 with specificity (57.5%), sensitivity (85.0%) and diagnostic efficacy (74. %). Then they are followed by MDHL at cut off 1.487 with specificity (50.0%), sensitivity (86.7%) and diagnostic efficacy (72.0), then England and Fraser with cut off 8.9 with specificity (50.0%), sensitivity (80.0%) and diagnostic efficacy (68.0%), and lastly MCHD with cut off 0.296 with specificity (72.5%), sensitivity (61.7%) and diagnostic efficacy (66.0%). Values above these cut off levels indicate β-TT whereas values below these levels indicate IDA except for E&F formula where <8.9 cut off indicate β-TT and >8.9 indicate IDA.

Conclusion

Zaghloul 2 formula showed the highest efficacy in the differentiation of β-TT from IDA (85%) followed by MCI (74%) and MDHL (72%) then England and Fraser (68%) and lastly MCHD (66%). They can be used for screening in big population, being simple and inexpensive, and then followed by the usual confirmatory tests. Their real use comes in rural areas and primary care facilities where only red blood cell indices are handy. They can be calculated and the cases can be referred to secondary health care to take the confirmatory tests for diagnosis.
The Association between Silent Mating Type Information Regulator 2 Homolog 1 (SIRT1) Gene Polymorphism and Systemic Lupus Erythromatosis (SLE)
Authors: Megid Abeer Ibrahim Abdel , Kamal El-Din Manal Mohsen M , Morshedy Nashwa Aly , Kabiel Walaa Ahmed Yousry , Ismail Sarah Abdel Mohsen
Published: October 2021

Background

Systemic lupus erythematosus (SLE) is a chronic severe multisystem autoimmune disease that affects multiple organs being characterized by heterogeneous manifestations that may affect the skin, joint, heart, brain, kidney, hematopoietic and central nervous systems. It is characterized by autoantibody production for a variety of self-antigens, but it is specifically associated with anti-double stranded DNA (anti-dsDNA), and immune complex deposition. The Silent Mating Type Information Regulator 2 Homolog 1 (SIRT1) is a NAD-dependent deacetylase enzyme that plays an important role in regulating a variety of cellular processes, such as energy metabolism, cell-cycle progression, apoptosis, aging, immune system regulation and inflammation.

Aim of the Work

The aim of the present study is to investigate the association of SIRT1 rs3758391 gene polymorphism with SLE and to study its impact on disease progression to lupus nephritis.

Subjects and Methods

This is a case control study conducted at Ain Shams University Hospital, with a total of 50 participants including 34 patients diagnosed with SLE in addition to 16 age and sex matched individuals serving as a healthy control group.

Results

The results revealed no significant difference between the SLE patients and the controls as regards CC, CT and TT genotypes, yet there was a statistical significant difference between both groups as regards the C and T alleles.

Conclusion

The present study highlights that SIRT1 gene rs3753891 does not seem to influence lupus nephritis susceptibility and disease activity as indicated by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scoring. However, T allele may be a risk factor for lupus susceptibility.
Split face comparative study of microneedling with platelet rich plasma versus Fractional carbon dioxide laser with platelet rich plasma in treatment of atrophic post acne scars
Authors: Sallam Mohamed Abd Elnaeem , El Zawahry Khaled , Ali Mustafa Abdul Rahman Muhammed
Published: October 2021

Background

Acne scars, is a challenge for dermatologists, despite having multiple treatment modalities like microneedling, dermabrasion, Fractional CO2 Laser, dermal fillers, etc. However, monotherapy has been hardly satisfactory because of the polymorphism seen with the scars.

Objective

Comparison between microneedling with platelet rich plasma versus Fractional carbon dioxide laser with platelet rich plasma in treatment of atrophic post acne scars.

Patients and methods

This study was carried out in department of dermatology, venereology and andrology, in Kobry El-Kobba Military complex during the period (from September 2018 to July 2020 ) on 20 patients of both sexes aged from 20 to 60 years old presenting with Goodman and Baron Grade II, III, IV acne scars .

Results

The study revealed a statistically significant difference (p = 0.017) between Goodman and Baron scar grades on the right side of the face before and after treatment indicating that microneedling with platelet rich plasma was effective in improving acne scars. Also, there is a statistically significant difference (p = 0.010) between Goodman and Baron scar grades on the left side of the face before and after treatment, indicating that fractional CO2 laser with platelet rich plasma was effective in improving acne scars.

Conclusion and recommendation

Further controlled and randomized studies are needed to validate our findings in a larger cohort of patients and longer follow up.

Also, number of sessions might be more than 3 sessions.
Comparative study between the efficacy of topical sildenafil and topical minoxidil in the treatment of male androgenic alopecia
Authors: Al-Shabkhon Ali Abdulkareem , Halim Emam Adel Ahmed , Abd Elfattah Afify Ahmed
Published: October 2021

Background

Androgenic alopecia is the most common form of alopecia in men and women. Its incidence increase with age, many treatment modalities are available but results are variable. Androgenetic alopecia is a hereditary thinning of the hair induced by androgens in genetically susceptible men and women. Also known as male-pattern hair loss or common baldness in men and female-pattern hair loss in women. Thinning of hair usually begins between 12 and 40 years old in males and females. Inheritance is polygenic.

Aim of the study

To evaluate and compare the efficacy, safety and side effects of topical sildenafil and topical minoxidil in the treatment of androgenic alopecia

Patients and methods

This exploratory pilot study included 30 male patients suffering from androgenic alopecia. Included patients were divided into 2 equal groups based on treatment received; one group received 1% topical sildenafil and the other group received 55 topical minoxidil. Assessment of treatment response was done using trichoscopy.

Results

Sildenafil treated group showed statistically significant increase in VH and TH count at 18 cm point, 24 cm point after treatment compared to before treatment. While, temporal side showed statistically significant increase in VH only. minoxidil treated group showed statistically significant increase in TH count, T/V hair ratio and hair thickness at 18 cm point and temporal side after treatment compared to before treatment. VH count was significantly decreased after treatment compared to before treatment at 18 cm point. At 24 cm point, only TH was significantly increased after treatment compared to before treatment.
Comparison between the Efficacy of Intense Pulsed Light (IPL) versus Photodynamic Therapy with Methylene Blue in the Treatment of Nail Psoriasis
Authors: Shaheen Maha Adel , Hassen Samah Ibrahim , Omar Dakhli Azzahra
Published: October 2021

Background

Nail psoriasis is often refractory to traditional treatments, and patients with nail psoriasis usually demand a therapeutic option. Both photodynamic therapy (PDT) and intense pulsed light have been evaluated in nail psoriasis.

Objective

The objective of this study was to evaluate and compare the efficacy of IPL and methylene blue assisted photodynamic therapy in the treatment of nail psoriasis.

Patients and Methods

Twenty patients (15 males and 5 females) with mild to moderate psoriasis with nail affection were included in this study. Their age ranged from 24 to 71 years. The PDT used IPL as the light source and methylene blue as photosensitizer. Sessions were applied every 2 weeks for a maximum of 3 months, treating one hand with IPL and the other with PDT. The nails treated were evaluated at baseline, after 2 sessions, after 6 sessions and 3 months after the last treatment session according to the Nail Psoriasis Severity Index (NAPSI) score. Follow-up was performed after 2 sessions, after 6 sessions, and 3 months after the last treatment session.

Results

A decrease in NAPSI score was observed with both treatments and in both nail bed and nail matrix involvement. No statistically significant difference was found between PDT and IPL as regarding total NPASI score. However, total NAPSI score improved by 61% in MB-PDT group versus 47% in IPL group. Patient follow-up revealed the appearance of new lesions in 3 patients in the group of IPL, and in 1 patient in the MB-PDT after 6 months.

Conclusion

Intense pulsed light and methylene blue assisted PDT are a promising effective modalities of treatment of nail psoriasis, which are easy to use, safe, and nearly pain-free. This was confirmed by the improvement NAPSI score.
Intralesional Zinc Sulfate 2% Vs Intralesional Vitamin D In The Treatment Of Planter Warts
Authors: Saber Fatma
Published: October 2021

Background

verrucae are benign proliferations seen in skin and mucosae due to infection with papillomaviruses.

Aim and Objectives

the aim of this work is to compare the clinical efficacy of intra-lesional 2% zinc sulfate solution vs intralesional vitamin D in the treatment of planter warts,

Subjects and Methods

this is Three armed single blinded randomized clinical trial included 105 patients presented with planter warts, Patients were all recruited from the Dermatology outpatient clinic at Ain-Shams University Hospital and Almateria hospital during the period From July 2018 to July 2019, Patients included in the present study were divided into 3 groups, 35 patients per group by simple randomization process which could allocate patients to either of three arms randomly and each patient would have an equal chance to be allocated to either of the three arms,

Results

There was no statistically significant difference between the 3 studied groups as regard the response to treatment after 1st, 2nd and 4th session. While after the 3rd session, there was statistically significant increase in the numbers of partial responders in the 3 studied groups (P = 0.023),

Conclusion

the current study showed that intralesional injection of 2% zinc sulfate is a better therapeutic option in the treatment of planter warts in comparison with intralesional vit D,
Clinical, Trichoscopic And Immunohistochemical Evaluation of Autologous Adipose Derived Adult Stem Cell Injection in the Treatment of Female Pattern Hair Loss
Authors: Moneib Hoda Ahmed , Mohamed Ghada Fathy , Ahmed Naglaa Samir , El-Sayed Abou-Noor Mahy El-Bassiouny
Published: October 2021

Background

Cellular and cell-derived components of adipose-derived tissue for the purposes of dermatologic and aesthetic rejuvenation applications have become increasingly studied and integrated into clinical practice. The hair follicle goes through phases of growth, regression, and quiescence, and it is suspected that adipocytes secrete factors to promote activation of hair follicles dermal papilla cells, increasing migration, and proliferation in vitro; as well as increasing conversion of hair follicles from the telogen to anagen phase in vivo.

Objectives

Evaluation of efficacy and safety of adipose-derived adult stem cells (ADSCs) injection in hair follicle regeneration in female pattern hair loss (FPHL).

Methods

33 patients were included and divided into 3 groups according to Sinclair’s classification according to severity. ADSCs were extracted from lipoaspirate and injected into the frontoparietal scalp. Patients were assessed clinically, trichoscopically and immunohistochemically.

Results

At week 24, there was improvement of hair thickness and count, both in frontal and occipital areas. Histopathological and immunohistochemical assessment at week 12 showed decrease of perifollicular inflammation and decrease of DKK-1 immunostaining.

Conclusion

The use of ADSCs in treatment of FPHL in subjects included in this study showed improvement of perifollicular inflammation, in addition to density and thickness of hair.
Evaluation of the efficacy and safety of different dilutions of Mesobotox in Mid and / or lower face rejuvenation: Interventional study
Authors: El Rahman Nesma Saber Abd , Abdallah Salem Samar , Elfattah Afify Ahmed Abd , Mohamed Seoudy Wael
Published: October 2021

As life expectancy has prolonged nowadays, interest has increased to change patterns of life, which include improving the consequences of skin ageing through slowing the ageing process. There are two main processes of skin ageing either intrinsic or extrinsic. Intrinsic ageing reflects genetic background in which skin appears thin with exaggerated expression lines. However, extrinsic ageing is caused by external factors such as smoking, excessive use of alcohol, poor nutrition and sun exposure. Extrinsically aged skin appears predominantly not only by wrinkles, but also by pigmented lesions such as freckles, lentigines and patchy hyperpigmentation, and depigmented lesions such as guttate hypomelanosis. Epidermal and dermal atrophy, rough skin texture, flushing, erythema, telangiectasias, dilated pores and loss of tone and elasticity are also other signs of skin aging.

Over the past few years, the use of Mesobotox has broadened and it is now commonly used as rejuvenation procedure with different dilutions. Our work aimed to compare between three commonly used dilutions of Mesobotox regarding its efficacy and safety, as this comparison was not done previously.

Aim of the study

The aim of this work is to evaluate and compare between different dilutions of Mesobotox in mid and / or lower facial rejuvenation.

Patients and methods

We included 30 patients complaining of facial wrinkles. Patients were divided into three equal groups to study three different dilutions of Mesobotox 1:5, 1:7 and 1:10. Assessment of treatment response was done using 3D Antera camera.

Results

Assessment of treatment response using Antera camera in 1:5 dilution revealed statistically significant improvement in all the parameters (periorbital and midface) with more evident improvement after 1 month of treatment compared to after 6 months of treatment. With 1:7 dilution and 1:10 dilution, response revealed statistically significant improvement in most of the parameters (periorbital and midface) with more evident improvement after 1 month of treatment compared to after 6 months of treatment.
Treatment of Striae Alba using Fractional Radiofrequency with and without Lyophilized Growth Factors
Authors: Abdallah Marwa M. A , Abd Elfattah Afify Ahmed , Hussain Ali Al-Rubaiay Nuha
Published: October 2021

Background

Various treatment modalities have been applied to treat striae alba with low satisfaction rate. Fractional Microneedling radiofrequency provides deep dermal coagulation, thereby inducing collagen synthesis and tissue tightening. The addition of platelet lyophilized growth factors may add to the effect of fractional Microneedling radiofrequency.

Objectives

To evaluate and compare the efficacy and safety of fractional Microneedling radiofrequency alone or combined with lyophilized growth factors in the treatment of striae alba.

Methods

In this left-right comparative study, 25 patients suffering from striae alba on the abdomen received sessions of fractional microneedling radiofrequency with lyophilized growth factors on one side and with saline (as placebo) on the other side at 4 weeks interval. Patients‘ satisfaction was evaluated at the end of study using a questionnaire (Patients were asked the following questions: Are you satisfied with this treatment (completely satisfied, satisfied, partially satisfied, or not satisfied)?.

Results

There was a significant improvement in striae alba after treatment in both the lyophilized growth factors (p = <0.0001) and placebo sides (p = <0.0001), the lyophilized growth factors being superior (p = 0.002). Patient satisfaction was more on the LGF side (p = 0.034),where 6 versus 3 patients were completely satisfied. Erythema and hyperpigmentation were less on the lyophilized growth factors side.

Conclusion

The combination of fractional microneedling radiofrequency and lyophilized growth factors improves striae alba outcome.
Comparative Study between the Efficacy of Platelet Rich Plasma with Methotrexate and Methotrexate Alone in Treatment of Chronic Plaque Psoriasis
Authors: El Sayed Mahira Hamdy , El Husseiny Rania Mahmoud , Abdellatif Ola Atef Ibrahim
Published: October 2021

Background

Psoriasis affects up to 3% of the world's population or more than 125 million people. There is an urgent need for new treatment strategy, as up to 50% of patients are not satisfied with current therapies. We evaluated the efficiency of combined platelet rich plasma (PRP) and methotrexate (MTX) injection in management of psoriasis vulgaris and combared it with methotrexate injection only.

Objectives

The aim of this work is to compare between the clinical efficacy of platelet rich plasma with methotrexate and methotrexate alone in treatment of chronic plaque psoriasis.

Patients and Methods

Forty patients with chronic plaque psoriasis were divided into two groups. Twenty patients were assigned into combinational treatment group (PRP + MTX) and monotherapy group (MTX alone) consisted of another tweenty patients. All patients in combinational therapy group received autologous intralesional PRP at 0,4 and 8 weeks combined with methotrethate im injection once every week for 12 weeks, while patients in monotherapy group received only methotrexate im injection once every week for 12 weeks.

Results

There were statistically significant decreased DLQI score after 6 and 12 weeks of treatment in females compared to males only in group B, while no significant differences were found between males and females in group A patients, This could be attributed to the greater concern in females as psoriasis is considered as a cosmotic problem.

Conclusion

Combination treatment of PRP with MTX is more effective than MTX alone in treatment of psoriasis vulgaris.
Nasal Steroids Use in the Prevention of Symptomatizing Adenoid Regrowth after Adenoidectomy
Authors: Ezzat Waleed F , Elczz Tamer A. Abo , Marouf Ahmed M , Ahmed Eman M
Published: October 2021

Background

Regrowth of the adenoids is a well-recognized entity. Intranasal steroids for children with adenoid vegetation can provide an alternative to revision surgery.

Objective

To assess the ol' using nasal steroids to prevent recurrence of adenoid hypertrophy and related symptoms after adenoidectomy.

Methods

Controlled clinical trial. One hundred patients after adenoidectomy were divided randomly into 2 groups. Group I were patients performing surgery on odd days of the month received postoperative intranasal steroid [fluticasone propionate (50 mcg/metered dose per nostril per day)] and Group Il were patients performing surgery on even days of the month received intranasal saline spray starting at postoperative week 2 after wound healing. Both medications will be adninistrated for 8 weeks postoperatively. Patients will be followed up for minimum of 6 months by using modified SNOT Score to suit children in reporting the degree of the symptoms and i!' needed nasopharyngeal lateral X-rays.

Results

Highly significant difference between both groups after 6 months postoperatively.

Conclusion

The use of intranasal steroids may obtain successful results in children to prevent adenoid regrowth and recurrence of related nasal symptoms after adenoidectomy. The most appropriate drug, the most efficient dose, and optimal treatment duration need to be investigated and determined.
Systematic Review of The Outcome of Different Modalities of Voice Rehabilitation Following Total Laryngectomy
Authors: Mohamed Ahmed Adly , Hamdy Tarek Abdel hamid , Askoura Anas Mohamed , Ghaly Mohamed Samir Ahmed Kamal Mohamed
Published: October 2021

Background

Speech impairment occurs in 34-70% of head and neck oncologic patients. Management of this impairment is through surgical and nonsurgical methods. Progress in voice rehabilitation following total laryngectomy has over the last 30 years, made an enormous difference in the whole concept of the management of laryngeal cancers.

Objective

To explore the outcome of different options of voice rehabilitation after total laryngectomy and the advantages and disadvantages of each method in order to improve the quality of life of laryngectomized patients and the suggestion of future directions for research.

Patients and Methods

The Aim of this work is to provide cumulative data about the efficacy and safety of the outcome of different modalities of voice rehabilitation following total laryngectomy. This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Metaanalyses (PRISMA) statement guidelines.

Results

Voice rehabilitation is one of the most important determinants of the quality of life after total laryngectomy. Recent advances in prosthetic voice devices have made such devices the gold standard for voice rehabilitation. They are thus preferred and used more often than old methods (esophageal speech and artificial larynx).

Conclusion

Although, no single method is considered to be the best for every patient, the tracheoesophageal puncture has become the most preferred method in the past decade. But it is not always possible in all patients, the results of this study indicate that ES, when achievable, is a viable option that should be considered by surgeons when making intervention decisions on patients, and should be revived when indicated. But we need much more studies.
Effect of using smart phones on balance functions
Authors: Hazzaa N , Hassan DM , Mahmoud Sh
Published: October 2021

Objective

To investigate the effect of visual fatigue caused by smart phone on the balance function.

Subjects and Methods

Forty subjects divided into 2 groups were included in the present study . Group I, twenty normal healthy subjects with mean age of 28.8 years. Group II, twenty subjects with a clinical diagnosis of peripheral vestibular disorder with mean age of 38.85years. They were subjected to a computer vision syndrome questionnaire (CVS-Q) , occulomotor tests of videonystagmography (VNG) and sensory organization test (SOT) of computerized dynamic posturography (CDP) before and after visual fatigue induction.

Results

Significant differences existed between C5, 6 and composite scores in group I and in C4 and composite scores in group II after visual fatigue induction. However, there was no significant difference between occulomotor tests in both groups after visual fatigue induction.

Conclusions

The smart phone use can affect the balance function in healthy subjects and augment the deficit in those with balance problem. Reducing visual fatigue should be considered through various procedures as taking proper rest, adjusting the brightness of screen, avoid any wrong posture and using filters if possible.
Impact of Urinary Incontinence on Physical Performance and Quality of Life (QOL) among a group of elderly in Cairo
Authors: El-gharib Alaa K , Manzour Ayat F , El-Mallah Reem , El Said Salma M.S
Published: October 2021

Background

Urinary incontinence (UI) is a common disorder that particularly affects the elderly population worldwide. UI can be associated with poor quality of life (QOL) of this vulnerable population, as it leads to the limitation of their physical and social activities of daily life. Additionally, it has a psychological and economic burden on individuals, health care services and society.

Objectives

This study was performed to measure the frequency of UI and to determine its impact on the overall QOL of elderly, physical performance and activities of daily living.

Participants and Methods

A cross-sectional study was performed on attending the four Primary Health Care centres (PHCs) of El-Obour City. Data collection was done in randomly chosen days every week. All elders aged 60 or above, who attended the PHCs those days, were included until a sample size of 150 elderly was obtained. The International Consultation of Incontinence (ICIQ) was used to detect urinary incontinence, assess its type and severity while, SF-12 was used to assess quality of life (QOL) with its mental and physical components. All study participants underwent short physical performance battery balance, gait and chair tests

Results

The overall frequency of UI was 38% among the studied elderly. UI ranged from mild (12.3%) to moderate (57.9%) and severe (29.8%). Among incontinent participants, the frequency in men was 47.4% and in women was 52.6%. The frequency of stress, urge, mixed and other UI were 7%, 33.3%, 40.4% and 19.3% respectively. Incontinent elderly had significantly lower QOL as regards mental and physical indices than their continent counterparts. UI severity was inversely related to physical performance.

Conclusion and recommendation

UI has a high-frequency rate among the elderly population, and it has a significant impact on all QOL domains as well as on their physical performance. It is recommended to set up management plans and strategies in geriatric health care facilities to prevent UI and its impact on the physical and mental health of this vulnerable population.
Efficacy of peritoneal dialysis on encephalopathic patient with Citrullinemia type I
Authors: Gamal Radwa , Khalifa Ola A
Published: October 2021

Citrullinemia type I (CTLN1) clinical spectrum includes an acute neonatal form ("classic" form) and a milder late-onset form (“non-classic" form). Infants with classic form appear normal at birth. Shortly thereafter, they experienced hyperammonemia and develops symptoms. Without prompt intervention, rapid neurological deterioration with seizures, spasticity, loss of consciousness and even death can occur. Continuous venovenous hemofiltration should be started in neonates and children with ammonia levels > 500 µmol/L or even at lower levels if there has been an inadequate response to medical management after 4 hours. Alternatively, but only in centers that lack ability or expertise to perform extracorporeal therapy, peritoneal dialysis can be utilized. The hallmarks of dialysis is rapid lowering of plasma ammonia concentration to avoid neurotoxicity and irreversible brain damage.

Objectives

To evaluate the effect of peritoneal dialysis on plasma ammonia levels and the clinical outcome in an encephalopathic Egyptian patient with CTLN1.

Patient and Methods

A 2.5 year old male patient with a classical form of CTLN1was recruited. The first presenting symptom of the patient was poor suckling and disturbed conscious level at the age of 5 day. He was admitted to neonatal intensive-care unit (NICU) with hyperammonemic encephalopathy and abnormal pattern of breathing. He developed apneic attack and underwent mechanical ventilation. The diagnosis of CTLN1 was established with elevated plasma ammonia concentration (350 µmol/L) and plasma citrulline concentration (2570 µmol/L). The patient was managed with peritoneal dialysis for 4 days, together with protein restriction, sodium benzoate, arginine therapy and high caloric intake.

Results

Plasma ammonia level was decreased with improvement of general condition and conscious level after dialysis. Upon discharge from NICU, the patient was referred to our Genetic clinic and no history of further hospital admission since then. Mild developmental delay mainly cognitive was noted during his regular clinic follow up.

Conclusion

CTLN1 can present with hyperammonemic encephalopathy which could be lethal if not promptly managed. Peritoneal dialysis proved to be an effective therapy of reducing plasma ammonia rapidly and improving outcome of the patient.
Endovascular Laser Therapy versus Open Surgery for the Treatment of Primary Varicose Veins of the Lower Limb
Authors: Mohamed Hazem Abd Elsalam , Wahba Assist. Prof. Dr. Ramez Mounir , Fawzy Fawzy Salah , Gebrael Beshoy Maher Yacoub
Published: October 2021

Background

Venous drainage of the lower extremities is accomplished by a network of superficial veins connected to the deep veins by small perforator veins. Through a variety of pathophysiological mechanisms, weakness develops in the vein wall that results in varicosity over time. Varicosities typically form in the greater and lesser saphenous veins but also develop in branch vessels. Obstruction of the iliac veins or inferior vena cava can result in extensive varicose veins

Objective

s: The aim of this work is to compare the outcome of endovascular laser therapy versus open surgery in management of primary varicose veins in lower limb.

Patients and Methods

Type of study is a prospective, randomized, clinical study. This study was conducted on 30 patients with primary varicose veins of the lower limb, 15 patients were subjected to endovascular laser therapy for treatment of varicose veins of the lower limb (EVLA group) and 15 patients were managed by standard open surgery for treatment of varicose veins of the lower limb (surgery group). The patients were randomized selected from surgery clinic in Eldemerdash Hospital. The work was carried out in the period from June 2017 to December 2018.

Results

Both groups were well matched regarding age(P = 0.352) and sex (P = 0.713), type of vein diseased(P = 0.913), CEAP classification (P = 0.910) and also regarding BMI (P = 0.761). Regarding preoperative venous clinical severity score, the median(IQR) for group A (surgery group) was (5), and for group B (laser group) was (5) without statistical significant differences between both groups (P value =0.524). Many studies have shown that there was some difference in between two methods of treatment of primary varicose veins of the lower limbs open vascular surgery and endovascular laser therapy. Regarding Six weeks post-operative VCSS assessment, the VCSS score in the surgery group was statistically significantly higher (p < 0.001). However, at one and two years after the intervention The VCSS scores converged and the difference between the groups was no longer statistically significant.

Conclusion

The presented results show that intreatment of varicose veins with both endovascular laser ablation and open surgery there was improvement in the clinical status of the patient occur after both but EVLA was more effective early which was observed by measuring venous clinical severity score. EVLA show distinct advantages over open surgery especially in post operative pain, analgesia use and time needed to return to work.
Comparison between Crystalloid Versus Colloid in Septic Shock
Authors: Amer Mohamed Ahmed Mahmoud , Eskander Moheb Shraby , Ryad Fady Markos
Published: October 2021

Background

Fluid resuscitation is a critical component to the emergency department (ED) management of patients with sepsis and septic shock. Fluids are administered to patients with sepsis in order to augment cardiac output and improve tissue perfusion and oxygenation. Recent evidence has suggested that the composition of fluids used in sepsis resuscitation may affect patient-centered outcomes.

Objective

To systematically review the effects of colloids compared with crystalloids in fluid resuscitation for septic shock.

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2017.

Data Extraction

If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion

In contrast to 0.9% NS, balanced crystalloid solutions contain significantly lower concentrations of chloride. Instead of large amounts of chloride, balanced solutions contain organic anions (i.e., lactate, gluconate, citrate, acetate) which act as physiologic buffers and are rapidly converted to bicarbonate upon administration. In addition, balanced solutions have less of an adverse effect on acid-base equilibrium than 0.9% NS. Balanced solutions also contain varying amounts of cations (i.e., potassium, calcium). Many critically ill patients across the world receive HES solutions for resuscitation. HES solutions are defined by their molecular weight and degree of hydroxyethylation. Recent evidence has demonstrated significant harm with the use of HES solutions. The administration of albumin in the critical patient is not associated to demonstrated adverse effects, though it should be reserved for specific patient groups in which it has been shown to offer benefit.
Comparison between Early Results of Laparoscopic Mini Gastric Bypass and Sleeve Gastrectomy regarding Weight Loss, Remission of Type II Diabetes Mellitus and Hypertension
Authors: Kayal Awad El , Elsadek Hossam , Ebrahim Mohamed , El din Ebrahim El Ghamrawy Mohamed Salah
Published: October 2021

Background

Bariatric Surgery leads to a dramatic improvement in morbid obesity and associated type 2 Diabetes Mellitus (T2DM) and hypertension.

Objectives

The aim of the study was to compare between early results of Laparoscopic Mini Gastric Bypass and Sleeve gastrectomy regarding excess weight loss, remission of Type II diabetes mellitus and hypertension.

Patients and Methods

Type of the study, retrospective study. study setting, Our study was carried out at The General Surgery Department Ain Shams University Hospitals. study period,. All cases were operated during the period February and march 2019. Follow up of patients 6 months after operation was done (retrospective study). Last follow up was done on September 2019. The study included 50 patients aged 18-60 years with Type II Diabetes Mellitus and hypertension of at least 6 months duration, BMI 35 65 kg/m2 for at least 5 years.

Results

In this study There was no statistical significant difference between studied groups as regard age,gender,and baseline clinical data.

there was a statistical significant difference between patients in LMGB group as well as between patients in LGS group before and six months after surgery as regard weight in kg, BMI and HbA1C and.remission of hypertention (P value 0.000).

there was high statistical significant difference between studied groups as regard percentage of change of weight and BMI(P value 0.000) However, there was no statistical significant difference between studied groups as regard percent of change of HbA1C. (P value 0.613),remission of T2DM.(p value 0.123 ) and control of hypertension. (p value 0.136 ). Further results and data could be reached on long-term follow up of patients involved in this study.

Conclusion

Patients receiving mini-gastric bypass had more advantageous indexes than patients receiving sleeve gastrectomy, such as higher six months EWL% (excess weight loss), higher T2DM remission rate and higher hypertension remission rate. Especially on long term follow up and that was proved by meta analysis of previous studies but on short term follow up there is no statistical singnificant difference between both studied groups except in percentage of change of weight and BMI.

Mini-gastric bypass is simple, safe and more effective bariatric procedure than laparoscopic sleeve gastrectomy.
Prospective study to evaluate the value of Identification of nerves crossing inguinal canal during inguinal mesh hernioplasty
Authors: Abdraboh Ayman Abdullah , Hafez Ramy Fouad , Abozeid Mohammed Elsayed Youssef
Published: October 2021

Background

Long-term morbidity associated with open inguinal hernia repair mainly consists of postoperative chronic pain. The mechanism responsible for the development of this postoperative pain is thought to be the entrapment, inflammation, and fibrotic reactions of the nerve around the mesh.

Aim of the Work

To analyse and provide comprehensive data on their incidence (identification rates), anatomical characteristics, and possible sources of heterogenecity, to decrease the risk of iatrogenic injury/ entrapment to these nerves during inguinal hernioplasty.

Patients and Methods

This study identified 40 patients who underwent inguinal hernia repairs with either routine repair or nerve identification and preservation. As several studies point out, a nerve-recognizing procedure is a logical step for minimizing postoperative groin pain. Such an approach can be advocated for two reasons: identification of the nerves for preservation or for performing standard neurectomy in case of interference with the position of the mesh.

Results

In the present study, there was no difference in pain scorings at one or 3-months after repair between different surgical techniques in patients undergoing open repair of a primary inguinal hernia. In present work, in addition to identifying and preserving all neural structures, specific maneuvers have been adopted for preventing postherniorrhaphy inguinodynia

Conclusion

The results indicated that routine nerve identification and preservation was associated with a significantly lower incidence of postoperative neuralgia compared with no nerve identification.