bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietary Habits and Perceived Barriers of Healthy Eating among Healthcare Workers in a Tertiary Hospital in Egypt: A Cross Sectional Study
Authors: Abouelezz Nahla Fawzy , Ahmed Waleed Salah Eldin , Elhussieny Doaa Mahmoud , Ahmed Gulsen Saleh , Zaky Mona Sayed Mohamed Elsayed
Published: November 2024

Background

Healthcare professionals often possess a strong awareness of the significance of good dietary habits due to their knowledge of nutrition and health. However, their demanding schedules, high-stress environments, and irregular working hours can pose significant barriers to maintaining healthy eating habits.

Patients and Methods

The current cross-sectional study was conducted to measure the prevalence among a sample of 373 Health Care Workers (HCWs)at Children’s Cancer Hospital Egypt. Data was collected using structured an interview questionnaire that includes socio-demographic characteristics, Job characteristics, history of chronic diseases, assessment of the dietary habits of the participants using the validated Rapid Eating Assessment for Participants - Shortened Version (REAPS), and barriers of healthy eating.

Results

Approximately half of the participants failed to adhere to the dietary recommendations for whole grains, vegetables, fruits, and dairy products. More than half of them usually and sometimes consume fried foods and added sugars during the week. The total mean score of dietary habits of the studied group was 26.55 with sd. 3.71 and range (15 - 37), suggestive of a lower diet quality than the average general population in the US. The average REAP-S score for a U.S. omnivorous diet is 32 with higher scores indicating healthier diet. The existing study results demonstrated that there is high significant correlation between studied group total score of dietary habits and their age. There is also significant difference between studied group total score of dietary habits and their working hours as the total score decreases within group who work more than 8 hours. On the other hand, there is no statistically significant difference between studied group total score of dietary habits and the rest of other demographic data. The current study results showed that according to HCWs; two fifth of the participants reported busy lifestyle (48.9%) and irregular work hours (39.8%), around one quarter of them reported willpower (27.4%) and healthy options are not as readily available as unhealthy (21.5%) and only (17.9%) of them reported price of healthy foods as barriers of healthy eating.

Conclusion

according to the results of the present study, there is a need for initiatives to promote healthier eating habits among healthcare personnel. The current work processes and policies should be reviewed in order to organize workload in ways that allow for enough break times for HCWs, introduce mandatory regular checkups for HCWs in each practice setting to monitor their health and adopt hospital-wide electronic applications that help HCWs to plan for and monitor their diet plans.
Correlation between MDCT and Postoperative Histopathology in the Staging of Laryngeal Carcinoma
Authors: Ellithy Abdelrahman Aly Yahia , Shebrya Naglaa Hussein , Elsersy Hesham Abdelaty Abdelkader , El-Mahdy Manal Mohamed , Hamed Wafaa Raafat Abdel
Published: November 2024

Background

The advantages and disadvantages of CT and MRI in the pre-operative assessment of laryngeal carcinoma still need to be further studied. Multidetector CT is the first line imaging investigation for staging laryngeal carcinoma. Evaluation of laryngeal SCC requires a contrast CT study of the neck. Excellent images of the neck are obtained using a multidectector CT (MDCT) following the injection of an iodinated contrast agent.

Aim of the Work

To assess the accuracy of preoperative CT staging of laryngeal tumours, and to measure its specificity for cartilage invasion, by comparing imaging with histologic cross-sections of surgical specimens and to clarify impact of these diagnostic modalities on pretherapeutic staging of laryngeal carcinoma.

Patients and Methods

Our study is a prospective study consisting of 30 patients with laryngeal carcinoma all underwent surgical treatment at Otorhinolaryngology department of Faculty of medicine, Ain Shams University.

Results

In our study CT showed highest accuracy in preepiglottic space, paraglottic space and Aryepiglottic fold lesions (96.7%), and was least accurate in cartilage invasion (73.4%). In our study the T stage was correctly determined by CT scan in 26 out of 30 cases. The consistency between perceived T stage by CT and histopathological analysis was highest for T3 (63.3%).

Conclusion

Contrast enhanced CT scan of the neck remains a precise and non-invasive imaging method for the staging of laryngeal carcinoma with high accuracy.
The Correlation between Doppler Assessment of Cerebral Blood Flow Changes and Common Neonatal Intracranial Lesions
Authors: Maarouf Rania Ali , El Rahman Ibrahim Marwa Elsayed Abd , Samier Elsayed Elhamaki Ahmed Mohamed
Published: November 2024

Background

Transcranial ultrasonography, in experienced hands, is an outstanding tool to detect brain abnormalities in preterm and full-term infants, and to follow the progression of these lesions. Doppler sonography is an excellent modality for assessment of the cerebral vasculature in the newborn and provides valuable information about cerebral vascular anatomy.

Aim and Objectives

to discuss the value added by transcranial Doppler assessment of blood flow in major intracranial cerebral arteries to brain status evaluation in neonatal intracranial hemorrhagic and ischemic conditions by employing Doppler techniques.

Subjects and Methods

This was a prospective cohort study that was carried out at tertiary care centers.45 neonates admitted to the neonatal intensive care unit were enrolled based on having the clinical diagnosis of perinatal asphyxia and having ischemic and hemorrhagic cerebral changes on grey scale sonographic evaluation. Doppler interrogation of both anterior cerebral artery (ACA) and middle cerebral artery (MCA) was performed bilaterally. Follow up evaluation was performed upon discharge. It was conducted from October 2022 to April 2023.

Results

There was a statistically significant difference between the studied groups as regard (APGAR Score at 1 min and 5 min), (peak systolic velocity (PSV) (cm/s) of ACA and resistive index (RI)), (peak systolic velocity (PSV) (cm/s) of MCA and resistive index (RI)), Correlation between Severity of hemorrhagic and ischemic cerebral changes with other studied Parameters except in gestational age and body weight.

Conclusion

Ultrasonographic features and cerebral blood flow parameters are useful for the early diagnosis of hypoxic-ischemic encephalopathy and help predict outcome. In the presence of more extensive hypoxic-ischemic brain injury and statistically significantly lower peak systolic velocity and higher resistive index in the anterior and medial cerebral arteries, the outcomes were poorer.
The Role of Ultrasound in Assessment of Disease Activity in Inflammatory Bowel Disease Patients
Authors: Kotb Soltan Ahmed Mohamed , Gaafary Sahar Mohamed El , Ahmed Aya Yassin , Abdulhafiz Essam Mohammed , Ahmed Elessawy Hagar Ahmed
Published: November 2024

Aim

This study aim to evaluate the role of Ultrasound in assessment of disease activity in Inflammatory Bowel Disease patients (IBD).

Patients and Methods

The was performed at Radiology Department and involved a diagnosed cases of Inflammatory Bowel Diseases referred from the Gastroenterology Unit, Ain Shams University Hospitals. A total Thirty six patients inflammatory bowel disease patients (Ulcerative colitis and Chron's disease) were subjected to Intestinal Ultrasound assessment (IUS), Fecal Calprotectin (CP) analysis and calculation of the Clinical Activity Indices. Twenty five patients were subjected to Endoscopic Activity Assessment. Intestinal Ultrasound (IUS) parameters including intestinal wall thickness (BWT) and intestinal bowel wall vascularity, were compared with Endoscopic Activity, Fecal Calprotectin levels (CP) and Clinical Activity Indices.

Results

Among the thirty-six patients, there were fourteen diagnosed Chron`s cases (38.9%) and twenty-two Ulcerative Colitis cases (61.1%). Roc curve analysis revealed the ability of the ultrasound bowel wall thickness (BWT) to differentiate between mild and moderate disease activity in IBD patients with sensitivity of 90.91% and specificity of 100.0%, with area under curve (AUC) of 0.909 using the endoscopic activity as a gold standard. A statistically significant difference was found between the (BWT) measurements and Simple Endoscopic score (SES-CD) (P = 0.002) as well as between the (BWT) measurements and Endoscopic Mayo score (P = 0.001). A statistically significant correlation was found between the fecal CP levels and Intestinal bowel wall thickness among Ulcerative colitis and Chron's patients with (r = 0.708, P < 0.001) and (r = 0.736, P < 0.01) respectively. There was also statistically significant difference between the Clinical Activity Indices (Harvey-Bradshaw Index and Partial Mayo Score) and the (BWT) among both the Chron's and Ulcerative colitis patients with P-value (0.004) and (0.001) respectively. A statistically significant difference was found between Doppler (Limberg Score) and SES-CD endoscopic activity score (p = 0.009) as well as between Doppler (Limberg Score) and Endoscopic activity Mayo score (p = 0.005).

Conclusion

The results of the study suggest that the Bowel Wall Thickness (BWT) and Color Doppler Signal could serve as non-invasive parameters of detecting IBD activity. Intestinal US could be one of the promising methods for the detection of the disease activity as well as monitoring of IBD patients.
Role of High Frequency Ultrasound in Assessment of Acute and Chronic Muscle Injuries in Comparison to MRI
Authors: Fahmy Marwa Ibrahim , Louka Amir Louis , Basuony Ahmed Mohamed , Dessouky Mohamed Abozeid Farid Ibrahim El
Published: November 2024

Background

The most common mechanism of injury of muscles is related to muscle strain (indirect muscle injury), mainly in the lower limbs. Muscles are at risk for disruption during eccentric contraction, as the force of active contraction is added to the passive stretching force applied to the myotendinous junction (MTJ). Although clinical examinations remain very important, it has been shown that radiological findings can aid clinicians in the initial assessment.

Objective

To evaluate the accuracy and specificity of high frequency ultrasound in identification and characterization of acute and chronic muscle injuries in comparison with MRI.

Methods

This ultrasonography & cross sectional study was done in private radiological centers with a period of 24 months on a random sample of 30 patients. Our study included 30 patients complaining of traumatic acute and chronic muscle injuries, 26 males (86.7%) and 4 females (13.3%), ranging in age from 18 to 55 years with a mean age of 37.5 years.

Results

The accuracy, sensitivity & specificity of ultrasound in detecting all muscle injuries in comparison to MRI: 86.7%, 87.5% & 83.3% respectively. The accuracy, sensitivity & specificity of ultrasound in detecting acute muscle injuries in comparison to MRI: 66.7%, 66.7 % & 66.7% respectively. The accuracy, sensitivity & specificity of ultrasound in detecting chronic muscle injuries in comparison to MRI: 95.2%, 94.4% & 100% respectively.

Conclusion

Ultrasound is highly operator dependent, useful for diagnosis of chronic muscle injury in comparison to the MRI, yet with pitfalls in acute muscle injuries, yet the ultrasound classification criteria for muscle injury can be used to predict the severity of injury and guide decision on the type of treatment and MRI is still considered the main diagnostic tool for muscle injuries and classification.
Role of DWI in Assessment of Anterior Cruciate Ligament Pathology
Authors: Sharkas Hossam Gamal , Ekladious Mena Elerian Youssef , Habib Lobna Abdelmoneim , Sakr Hossam Moussa
Published: November 2024

Background

The anterior cruciate ligament (ACL) is an important structure in maintaining the normal stability of the knee, yet with anterior cruciate ligament being the most commonly injured ligament, differentiation between complete and incomplete tears is crucial to provide non-operative management in incomplete tears patients. Magnetic resonance imaging (MRI) of the knee joint is routinely performed for the diagnosis of tear of cruciate ligaments. However, in some cases, is tough because the ligament fibers maybe obscured by edema. Ligament fibers have been shown to be better visualized on diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping and therefore, ADC mapping may be able to verify if the ligament is continuous or not for accurate diagnosis of incomplete tears.

Objective

To determine the role of diffusion-weighted (DW) magnetic resonance imaging (MRI) in diagnosing and differentiating between complete and partial anterior cruciate ligament (ACL) tears and to compare it with conventional MRI sequences.

Methods

This is a prospective study approved by Ain Shams university ethics committee was conducted on 20 patients with clinically suspected ACL pathology from September 2021 to September 2023. Patients were collected by consecutive sampling. All patients underwent MRI with both conventional and DWI/ ADC mapping sequences and the findings on both sequences were assessed independently by two high experienced radiologists in musculoskeletal imaging and the findings were compared with clinical diagnoses, follow up and arthroscopic results when available.

Results

For partial tears, 10 cases (50%) were identified using arthroscopy/follow-up, while observer 1 identified 12 cases (60%) and observer 2 identified 9 cases (45%) using DWI/ADC. For complete tears, 10 cases (50%) were identified using arthroscopy/follow-up, while observer 1 identified 8 cases (40%) and observer 2 identified 11 cases (55%) using DWI/ADC.

Conclusions

DWI and ADC are useful tools for diagnosing tears, particularly complete tears, but that caution should be exercised when using these techniques to diagnose partial tears.
Effect of Vitamin K2 on Progression of Coronary Artery Calcification by Multislice CT Examination
Authors: Ameen Israa Mohamed El , Ibrahim Ahmed Samir , Madkour Sherihan Said , Hatata Ahmed Ibrahim
Published: November 2024

Background

Coronary artery disease (CAD) is associated with high mortality around the world. Dyslipidemia, hypertension, diabetes and smoking are common risk factors for CAD. Coronary artery calcification (CAC) and especially progression in CAC is a strong predictor of acute myocardial infarction (AMI) and cardiovascular mortality. Vitamin K2 is thought to inhibit vascular calcification through many different mechanisms.

Aim of the Work

To study the effect of Vitamin K2 on coronary artery calcification using the Agatston calcium score.

Patients and Methods

This study was conducted on 30 patients with pre-existing CAD who were randomly assigned in a 1:1 ratio to either oral Vitamin K2 supplementation or no treatment for 6 months. Non contrast cardiac MDCT examination was done at baseline and after 6 months to detect the change in CAC score.

Results

46.6 % of the cases who took the vitamin K2 (MENA Q) drug had their post 6 months follow up calcium score decreased and 53.3 % of them had their post 6 months follow up the same as the baseline, while 80 % of the patients in the control group showed an increase in their coronary artery calcium score and only 20 % of them showed no change in their coronary calcium score remaining the same as the baseline done at the start of the study.

Conclusion

Our study confirms that by using the CAC Agatston score, Vitamin K2 can have a role in decreasing the progression of coronary artery calcification.
MRI Evaluation of Sacroiliac Joint Affection in Post-COVID Patients
Authors: Abdallah Khaled Ali Abdelfattah , Abdel Rahman Korashi Hazem Ibrahim , Abd Almaged Mohamed Shaimaa Khalil
Published: November 2024

Background

SARS-CoV-2 has been a worldwide pandemic, which caused a great health burden to many countries and societies, both for the acute presentation, and the sequalae. The fact that the virus targets specific receptors that are shared between lung tissue and other body tissues led to the phenomenon of post-COVID manifestations outside the lungs, including but not exclusive to the joints, causing the emergence of a new entity of diseases, known as post-COVID arthritis.

Aim of the Work

to evaluate the sacroiliac inflammatory involvement in patients who have suffered from COVID-19 using magnetic resonance imaging (MRI)

Patients and Methods

All eligible Post COVID patients referred from orthopaedics or rheumatology clinics to MRI unit for MRI of the sacroiliac joint in the previous year and the proceeding six months -set date: February 2023- and who met the inclusion and exclusion criteria (at least 30 patients) were included in the study in order to evaluate the sacroiliac inflammatory involvement in post-COVID patients.

Results

the first cross-sectional study with MRI in post-COVID19 sacroiliitis. our patients complained of typical inflammatory lower back pain after the resolution of infectious symptoms, with clinical features of acute sacroiliitis (insidious onset, night pain, morning stiffness, improvement with exercise and NSAIDs, radiation to buttocks), as described after different infections or in the context of reactive arthritis or seronegative spondyloarthritis. that most of the patients were in the third and fourth decades, with more females (63.3%) than males (36.7%). Among those patients, 83.3% showed bilateral affection of the sacroiliac joints, while those presenting with unilateral sacroiliitis represented 16.7% with more cases having right sided affection compared to those with left sided affection. Most of the patients were on Non-steroidal anti-inflammatory drugs, and almost all patients had complete recovery of symptoms. In few cases treatment required the intake of steroids. Only three cases required intra-articular steroid injection.

Conclusion

magnetic resonance imaging of the sacroiliac joints in post-COVID patients who suffered from low back pain few days to weeks after the infection with the virus, showed the joint affection to be in the form of bilateral sacroiliitis in most cases, with few cases presenting with unilateral affection mainly on the right side. We also found that the majority of these patients responded well and fully recovered from the symptoms on NSAIDs.
Diagnostic Performance of Artificial Intelligence for Cancers Detected in Screening Mammography
Authors: Yosry Mohamed Gamal ELdin Lina Abdallah , Ibrahim Marwa ELsayed Elmor Abdelrahman
Published: November 2024

Background

Breast cancer is the most common cancer type and the second cause of cancer- based mortality in women according to the 2020 global cancer statistics. Screening for breast cancer with mammography has shown a reduction in breast cancer mortality by many randomized trials and incidence-based mortality studies.

Aim of the Work

to emphasize the role of AI system in detection of breast cancer in digital mammogram. We hypothesise that the AI has accuracy that is comparable to human readers in breast cancer detection on Mammogram, and that integrating the AI into a standard screen- reading strategy increase the accuracy of cancer detection.

Patients and Methods

This is a prospective study (Diagnostic Accuracy Testing) conducted at the radiology department, Ain Shams University Hospitals. The main source of data for this study were the patients referred to the radiology department at Ain Shams university hospitals for screening mammography from March 2023 to August 2023.

Results

In our study 62.5% of the pathological lesions were on the right side, while 37.5% were on at the left side. - Regarding the agreement between radiologists and AI in the nature of the detected mass (Bengin / Malignant), the agreement between radiologist 1 Vs. radiologist 2 was 92.5%, while it was 86.5% between radiologist 1 Vs. AI. The agreement between radiologists 2 Vs. AI, it was 89.2%, So the best agreement was between radiologist 1 and radiologist 2,While the concordance between the analysis of the mammography and the pathological results was the highest by Radiologist 2 by accuracy 85% and sensitivity 100% followed by radiologist 1 as accuracy was 77.5% with 93.9% sensitivity, while the worst interpretation was by AI accuracy was 72.97% with 90% sensitivity, so the concordance between radiologists’ analysis and pathological results was stronger than that between AI and pathology.

Conclusion

We found that the unaided radiologist are having overall better performance than AI however, less experienced breast radiologists had a higher diagnostic performance with support from an AI system compared with reading unaided.
Ultrasound Guided Percutaneous Renal Biopsy Using 18-Gauge versus 16-Gauge Needles in Native Kidneys with Diffuse Renal Disease: Comparison Regarding Sample Adequacy and Complication Rates
Authors: Niazi Gamal Eldine Mohamed , El-Hemeily Mohammad Hicham Hassan , Mohamed Mariam Hossameldin Sayed
Published: November 2024

Background

Regardless of the advancements made in non-invasive diagnostic tools, Percutaneous Renal Biopsy (PRB) remains the corner stone for reaching a reliable diagnosis for most renal parenchymal diseases. Needle gauge is a key variable in determining the adequacy and therefore success of renal biopsy as it influences the number of glomeruli obtained in the sample. To date, there is still much debate over the appropriate needle size to use when trying to balance between meeting diagnostic requirements; whilst decreasing the incidence of complications. At present, 16G needles or 18G needles are used for percutaneous renal biopsy at our institute on basis of personal preference and experience, but there is still controversy about the effect and safety of 18G and 16G biopsy needles in terms of the two different diameters, with no irrefutable evidence to dictate the superiority of one needle gauge over the other within the present literature. This study was the first in the Middle East to address the effect of using different gauge needles on sample adequacy and complication rates in real-time US guided PRB.

Objective

To compare sample adequacy and complication rates between US guided PRB acquired using 16- Gauge versus 18- Gauge needles.

Patients and Methods

This study was a prospective study conducted at the Interventional Radiology (IR) Unit at Ain Shams University Tertiary Hospitals from December 2022 till April 2023, on a series of 60 patients who visited our radiology suite to undergo renal biopsy, with a total of 62 renal biopsies. The patients were randomly allocated into two separate groups based on the biopsy needle gauge that was used to retrieve their renal biopsy sample.

Results

This study showed that a 16G biopsy needle has no obvious advantage over an 18G needle in terms of the number of glomeruli and the adequate sample rate. Although the frequency of overall complications as well as major complications was higher in 16 G in comparison to 18 G group this difference was statistically non-significant yet held clinical implication.

Conclusion

The 18G needle appears to be as effective as the 16G for percutaneous renal biopsy regarding sample adequacy, with clinically significant lower rate of major complications.
Evaluation of Image-Defined Risk Factors Efficacy on Neuroblastoma Surgical Resectability
Authors: Hemdan Mona Hamdto Mahmoud , Mohammad Shaimaa Abdelsattar , Ahmed Khaled Aboualfotouh , Ali Ali Hagag
Published: November 2024

Background

Neuroblastoma (NB) is one of the most prevalent extracranial solid cancers in children that commonly occur in the adrenal glands (49%). Thus, monitoring the diagnosis, staging, treatment planning, response evaluation, and updating and discovering new International Neuroblastoma Risk Groups (INRGs) is an important method to facilitate the treatment process.

Patients and Methods

The clinical, radiological, pathological, and surgical data of 30 neuroblastoma patients were analyzed, preoperative image-defined risk factors (IDRFs) were present in 23 cases with the most two frequent IDRFs were encasement of aorta then invasion of the renal pedicles.

Results

The statistical analysis data represented 30 cases showed that there was significant correlation with preoperative IDRFs and the type of surgery as well as significant correlation between IDRF and primary tumor location. The results affirm that IDRFs remain a useful prognostic tool for neuroblastoma patients both for short and long-term outcomes.

Conclusion

Hence, the efficiency of using the image defined risk factor was predictable of surgical resectability and complication.
Role of Diffusion Weighted Imaging with Background Body Signal Suppression (DWIBS) in Evaluation of Breast Masses and Correlation with Histopathological Findings
Authors: Deif Allah Naglaa Sabry El-Sawy , Abdallah Randa Hossein , Hassan Mohammed Sobhi , Ibrahim Suzan Farouk
Published: November 2024

Background

Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is an important tool in breast imaging. Yet, it has two major limitations which are represented by its specificity and the use of contrast material. Diffusion weighted imaging (DWI) provides important functional information without the need for contrast material. A newly introduced Diffusion weighted imaging with back-ground suppression (DWIBS) sequence is an accurate and rapid tool for the identification and characterization of breast lesions, with its short examination time, high lesion-to-background contrast, and lack of need for intravenous contrast agents.

Objective

To assess the role of DWIBS sequence for evaluating breast masses and to compare DWIBS results with DCE-MRI in correlation with histopathological findings for intermediate, suspicious and malignant imaging results.

Methods

The study was conducted during the period from December 2020 t& January 2023. Thirty five patients were included in the study, referred from Ain Shams university hospitals sonomammography clinic to Ain Shams university hospitals MRI unit for further MRI assessment of breast masses (BIRADS 3, BIRADS 4& BIRADS 5), probably benign, suspicious and malignant- lesions on sonomammography imaging results. MRI breast protocol which included DCE-MRI and DWIBS sequences were obtained for characterization and were verified by core needle biopsy or excisional biopsy. The results were statistically analyzed. Sensitivity, specificity, diagnostic accuracy (DA), positive predictive value (PPV) and negative predictive value (NPV) were calculated for DCE-MRI and DWIBS. Apparent diffusion co-efficient (ADC) values were calculated with ADC <1.2 x 10-3 mm2/s were considered suspicious for malignancy. The results were then compared with the histological findings.

Results

35 female patients had 39 breast masses included in our study. By DCE-MRI, 8 (20.5%) of masses were categorized as benign and 31(79.5%) of masses were categorized as malignant. By DWIBS sequence, 7 (17.9%) of masses were categorized as benign and 32 (82.1%) of masses were categorized as malignant. By histopathology, 14 (35.9%) of masses were benign and 25 (64.1%) were malignant. DCE-MRI obtained accuracy, sensitivity, specificity, PPV and NPV values of 84.6, 100, 57.1, 80.6, 100 %, respectively. DWIBS sequences obtained accuracy, sensitivity, specificity, PPV and NPV values of 82.1, 100, 50, 78.1, 100 %, respectively.

Conclusions

DWIBS can be added to DCE breast MRI, to improve DCE-MRI sensitivity and specificity. It can as well be used instead of DCE -MRI sequences in certain circumstances as in cases of renal impairment, but with some limitations as DWIBS cannot assess the extent of the malignant process.
Magnetic Resonance Imaging Analysis of The Relationship Between Intercondylar Notch Angle and Anterior Cruciate Ligament Injury
Authors: Atwa Nourhan Mamdouh Abdelghafar , Nassef Mohamed Amin , Wahby Hemada Tarek
Published: November 2024

Background

The most damaged ligament resulted from knee joint injury is the anterior cruciate ligament (ACL), representing 50% of all knee injuries, However, the etiology of ACL tears is not com-pletely clear. Some studies showed morphological predispositions such as narrow intercondylar notch dimensions, Identifying anatomical factors that may predispose to ACL injuries could help to control the extrinsic risk factors to reduce the risk of injury.

Aim of the Work

to identify the associations between intercondylar notch angle and ACL injury and thus clarify its role in ACL injury. In this study, the angle formed by the femoral axis and Blumensaat line was defined as the intercondylar notch angle (INA). Our study was done retrospectively and included 30 case with acute ACL injury and 30 controls with intact ACL.

Patients and Methods

This study is a case control Study, the study was conducted at Ain Shams University Hospitals at Radiology department and the main source of data for this study was the retrospectively conducted scans and clinical history of the patients referred to the MRI section of the department of Radiology, Ain Shams University Hospitals.

Results

The INA (intercondylar notch angle) measurement was significantly different between the two groups (t = -5.530, p < 0.001). The case group had a higher mean INA (40.23±3.61) than the control group (34.93±3.81). The cutoff point was >38 with a sensitivity of 66.67%, specificity of 90%, positive predictive value (PPV) of 87%, and negative predictive value (NPV) of 73%. The INWI (intercondylar notch width index) measurement was significantly different between the two groups (t = 3.218, p = 0.002). The case group had a lower mean INWI (0.29±0.02) than the control group (0.31±0.02). The cutoff point was ≤0.314 with a sensitivity of 86.67%, specificity of 46.67%, PPV of 61.9%, and NPV of 77.8%. The INW (intercondylar notch width) measurement was not significantly different between the two groups (t = 1.747, p = 0.086) and The TCW (total condylar width) measurement was not significantly different between the two groups (t = -1.313, p = 0.195)

Conclusion

A narrow intercondylar notch (intercondylar notch index) < 0,31 and a large INA > 38 are risk factors in predicting the likelihood for ACL injury. The INA might be the factor with the strongest prediction for ACL injury.
Comparison between Magnetic Resonance Elastography and Diffusion-Weighted Imaging in Differentiation of Benign and Malignant Hepatic Focal Lesions
Authors: Elgayed Abd Allah Rana Sami Abd , El Fiky Sahar Mohamed , Ali Nagi Mona Ali Mohamed , Hassan Ayman Hassan
Published: November 2024

Background

With the widespread use of cross-sectional imaging techniques, the detection of focal liver lesions (FLLs) has become increasingly common. Many FLLs are incidental, and characterization with imaging is an effective means to reduce the need for invasive biopsies for histological confirmation.

Objective

To compare between MRE and diffusion–weighted imaging for differentiating benign and malignant hepatic focal lesions.

Methods

This Prospective study was conducte at department of Radiodiagnosis of National Hepatology and Tropical Medicine Research Institute “NHTMRI” in Cairo, Egypt, on 50 patients.

Results

Our study results revealed that in the comparison between diffusion and MRE to detect malignant lesions, the sensitivity and specificity of diffusion was 100% and 40.9% respectively, but for MRE was 89.3% and 100%, Also showed that MRE is significantly superior to DWI for distinguishing between malignant and benign FLLs, with 89% sensitivity, 100% specificity, and accuracy for MRE. Among all FLLs. the most frequent focal lesion HCC by 48.0% followed by hemangioma and inflammatory lesions by 26% & 12% respectively.

Conclusion

MRE provides a non-invasive quantitative parameter that may be useful for differentiating common benign and malignant FLLs. MRE performed better than DWI, and shows great promise as a non-invasive alternative to biopsy for the differentiation of benign and malignant FLLs and demonstrates additive value to conventional imaging. However, there is opportunity for further enhancement of the technique, particularly with regard to optimization of image quality and evaluation of smaller FLLs.
Imaging Finding in Different Molecular Cancer Breast Sub Types, A Cross Section Study
Authors: EL Hik Wael A Maher , Fahmy Marwa Ibrahim M , Gamal Noha M , Aly Shehata Khaled A
Published: November 2024

List of Abbreviations:

HER2 : human epidermal growth factor receptor 2.

HER2+/HER+ : Enriched (over expression) human epidermal growth factor receptor 2.

TNBC: Triple Negative breast cancer.

UOQ: Upper outer Quadrant.

UIQ : Upper Inner Quadrant.

CEM: Contrast enhanced Mammography.

CC: Cranio-Caudal breast View.

MLO: Mediolateral oblique View.
Role of Ultrasound in the Assessment of Pediatric Non Traumatic Gastrointestinal Emergencies
Authors: Elfeky Yomna Adel Mohamed , Elhameed Abeer Maghawry Abd , Yacoub George Ezzat Elkess
Published: November 2024

Background

Ultrasound has become an important diagnostic imaging modality in the evaluation of the gastrointestinal tract of children adding a new perspective to the imaging of this body system. US observes gastrointestinal dynamics without exposure to ionizing radiation and allows detailed visualization of the mural layers of the bowel wall. Since children are unable to give reliable history, evaluation and establishing the correct diagnosis is challenging.

Objectives

To assess the role of Ultrasonography and its diagnostic efficacy in the evaluation of pediatric non-traumatic gastrointestinal emergencies.

Patients and Methods

A cross-sectional study of 64 pediatric patients presented with non- traumatic gastrointestinal emergencies.

Results

64 patients were included in this study. 25 patients had acute appendicitis, 7 patients had complicated appendicitis, 23 patients had intussusception, 6 patients had hypertrophic pyloric stenosis and 3 patients had malrotation. Ultrasound sensitivity in the diagnosis of acute appendicitis was (90.6%), 22 out of 25 patients with acute appendicitis were correctly diagnosed by US. In the 3 other cases, US was negative for appendicitis which was confirmed by surgery. US sensitivity in the diagnosis of complicated appendicitis was (100%). As well as in the patients who had intussusception, hypertrophic pyloric stenosis and intestinal malrotation, US showed markedly high sensitivity reaching (100%). Establishing that Ultrasound has high diagnostic efficacy in assessing gastrointestinal emergencies as accuracy in diagnosing appendicitis was (90.6%) and accuracy in diagnosing intussusception, hypertrophic pyloric stenosis and intestinal malrotation was (100%).

Conclusions

Ultrasound is sufficient for the diagnosis of several gastrointestinal diseases that cause acute abdominal pain in pediatric patients helping to an accurate patient management in the emergency settings. Therefore, it is rapidly becoming an important imaging modality for the evaluation of acute abdominal pain, where satisfactory examination is often not achievable for the attending clinicians. Pediatric GIT non traumatic emergency conditions discussed are: Appendicitis, intussusception, hypertrophic pyloric stenosis and malrotation.
Validation of Methotrexate Intolerance Severity Score (MISS) Questionnaire to Measure Methotrexate Intolerance among Rheumatoid Arthritis Egyptian Patients
Authors: Tawfik Kabil Hagar Ahmed , Sherif Nahed Mounir , Eldin Elhossiny Mona Gamal , Nassif Mary Atef
Published: November 2024

Background

Rheumatoid arthritis (RA) is a systemic, autoimmune inflammatory disease whose manifestations occur in synovial joints and in different organs and systems, causing chronic pain, bone erosion and progressive disability. Methotrexate (MTX) is the most important disease modifying antirheumatic drug in the treatment of RA.

Objective

To validate MISS questionnaire in Egyptian RA patients as a tool for early detection of MTX intolerance and change of treatment at an early stage to prevent disease progression.

Patients and Methods

This study is a Cross Sectional Study Settled in Physical Medicine, Rheumatology and Rehabilitation (PRR) outpatient clinic of Ain Shams University hospital. The Arabic MISS was used in this survey. Statistical analyses were performed to understand associations between different MTX-intolerant and MTX-tolerant patients.

Results

A total of 80 patients were involved in this study. Of those, 67 (83.8%) were females with a mean disease duration of 6.9 ± 6.1 years. Intolerant patients had a higher patient global assessment (P = 0.036), Disease activity score 28 (P=.000) and Health assessment questionnaire score (P = 0.007) compared to those in tolerant patients. MISS questionnaire helps us to detect early MTX intolerance and actually we found high prevalence in Egyptian RA patients as MTX intolerance was observed in 48 (60%) patients, our finding revealed that behavioral intolerance is the predominant factor that directs MTX intolerance. In our study, the reliability of MISS questionnaire is measured by Cronbach’s alpha coefficient and it is 0.809 suggesting a good internal consistency of the survey items.

Conclusion

MISS questionnaire has good predictive ability to detect MTX intolerance.it gives great importance to anticipatory and associative symptoms. MTX intolerance is common; present in more than half of RA patients. Behavioral component is the main driver of intolerance.
Women’s Strategies to Cope with Harassment in Za’atari Camp and the Role of Humanitarian Reporting Mechanisms
Authors: Alhalawani Sarah , Al-Serhan Amani
Published: November 2024

The refugee experience is frequently marred by pervasive gender-based violence, particularly harassment, in refugee camps. Women, disproportionately affected due to entrenched gender biases, often suffer in silence due to societal stigma. In Za’atari Camp in Jordan, women face various forms of sexual and gender-based violence (SGBV), notably verbal harassment, exacerbating their plight amidst a culture of victim-blaming. While humanitarian efforts have made strides, challenges persist in reporting and adopting sensitive response mechanisms. This study aims to evaluate gaps in protection plans, response procedures, and reporting at Za’atari Camp, analysing coping mechanisms and resistance behaviours of women facing harassment. With 409 survey responses, findings reveal enduring verbal harassment and reporting barriers fuelled by fear of repercussions and survivor blaming. Addressing these challenges is crucial for the effective implementation of humanitarian policies and standard operating procedures, necessitating collective action to create a supportive environment for all women in the camp.
Evolution of a novel engineered tripartite viral genome of a torradovirus
Authors: Turina Massimo , Nerva Luca , Vallino Marta , Miotti Niccolò , Forgia Marco , Ciuffo Marina , Falk Bryce W , Ferriol Inmaculada
Published: November 2024

Viruses in the Secoviridae include monopartite and bipartite genomes, suggesting the possibility to study members of this family to experimentally address evolutionary transitions resulting in multipartitism. Torradoviruses are bipartite members of the family Secoviridae characterized by a genus-specific 5ʹ open reading frame, named P21, encoded by RNA2. Here, in a study originally intended to verify if P21 can function in trans, we attempted to provide P21 from a third P21-expressing construct under control of the 35S promoter and containing the 5ʹ- and 3ʹ-untranslated regions (UTRs) of wild-type (WT) RNA2. When this construct was combined with an RNA2 with a complete deletion of the P21 coding region we verified that the P21 provided in trans cannot immediately complement the mutant, but occasional systemic infections in a limited number of the inoculated plants display the presence of a tripartite virus with an actively replicating P21-expressing RNA3. Furthermore, in all the systemically infected plants investigated in six distinct experiments, this replicating RNA3 accumulates deletions in a small region inside the original 3ʹ-UTR provided by the cDNA clone. Such tripartite virus, which we obtained through deconstructing the coding potential of the RNA2 in two distinct RNAs, can be transmitted mechanically and by whiteflies, is competent for virion formation, and its RNA3 is encapsidated. It can be mechanically transferred for 11 serial passages without losing its infectivity or showing major genomic rearrangements. Furthermore, mixing equal amounts of WT and tripartite virus inocula in the same leaf resulted in plants systemically infected only with the WT virus, showing that the tripartite virus has lower fitness than the WT. To our knowledge, this is the first example of an engineered tripartite viral genome becoming stable through artificial evolution in vivo, in plants. This tripartite system was also used to derive a stable viral vector to express green fluorescence protein (GFP) systemically in the context of viral infection.
Endogenous viral elements: insights into data availability and accessibility
Authors: Ritsch Muriel , Brait Nadja , Harvey Erin , Marz Manja , Lequime Sebastian
Published: November 2024

Endogenous viral elements (EVEs) are remnants of viral genetic material endogenized into the host genome. They have, in the last decades, attracted attention for their role as potential contributors to pathogenesis, drivers of selective advantage for the host, and genomic remnants of ancient viruses. EVEs have a nuanced and complex influence on both host health and evolution, and can offer insights on the deep evolutionary history of viruses. As an emerging field of research, several factors limit a comprehensive understanding of EVEs: they are currently underestimated and periodically overlooked in studies of the host genome, transcriptome, and virome. The absence of standardized guidelines for ensuring EVE-related data availability and accessibility following the FAIR (‘findable, accessible, interoperable, and reusable’) principles obstructs our ability to gather and connect information. Here, we discuss challenges to the availability and accessibility of EVE-related data and propose potential solutions. We identified the biological and research focus imbalance between different types of EVEs, and their overall biological complexity as genomic loci with viral ancestry, as potential challenges that can be addressed with the development of a user-oriented identification tool. In addition, reports of EVE identification are scattered between different subfields under different keywords, and EVE sequences and associated data are not properly gathered in databases. While developing an open and dedicated database might be ideal, targeted improvements of generalist databases might provide a pragmatic solution to EVE data and metadata accessibility. The implementation of these solutions, as well as the collective effort by the EVE scientific community in discussing and setting guidelines, is now drastically needed to lead the development of EVE research and offer insights into host–virus interactions and their evolutionary history.
Inclusivity: Educational Experiences of Registered Nurses With Physical Disabilities
Authors: Mantlow Kimberly D. , Sullivan-Bolyai Susan , McGuire Anthony W. , Morris Nancy S.
Published: November 2024

AIM

The aim of the study was to describe registered nurses’ prelicensure educational experience as nursing students with physical disabilities.

BACKGROUND

Social and academic support help establish connections with the educational environment, but efforts to engage students with disabilities are inconsistent. Faculty support beyond required accommodations facilitates a sense of empowerment. Communities in academic settings for minority groups significantly increase the likelihood of academic success due to information-related social capital and social support.

METHOD

A qualitative descriptive design with semistructured interviews of 16 individuals with 14 different physical disabilities was used for this study. Data were analyzed using thematic analysis.

RESULTS

Four themes emerged: 1) I saved my energy for learning; 2) I was determined; 3) wanting to find my people; and 4) secrets, living a double life, with subtheme fear of judgment.

CONCLUSION

Identification of factors related to inclusion within the academic environment provides insight for improving the experiences of prelicensure nursing students with physical disabilities.
Treatment of 50 Acute and Chronic Wounds of Multiple Etiologies: A Case Series Looking at Outcomes and Utility of an Extended-Wear Transforming Powder Dressing
Authors: Cimaroli Sawyer , Lozada Danilo , Daniels James , Gillette Brian , Gorenstein Scott
Published: November 2024

Increasing healthcare costs, limited healthcare resources, an aging population, and lifestyle-related diseases make wound management a growing clinical, social, and economic burden. This case series investigated the use of a novel, biocompatible, polymer-based transforming powder dressing (TPD) that transforms in situ to a shape-retentive wound matrix upon hydration for treating wounds of various etiologies.

In this institutional review board-approved single-center retrospective case series, the researchers evaluated various acute and chronic wounds treated with TPD over a period of 2 years. Wounds were followed from the first TPD application up to 1 month after the last TPD application or until the wound healed or the patient was lost to follow-up, whichever came first. The researchers evaluated wound etiology, location, number of applications, change in wound surface area, and comorbidities.

The researchers identified 50 patients who were treated with TPD and had at least one follow-up visit during the retrospective study period. The majority of wounds treated with TPD were venous leg ulcers (n = 27) followed by traumatic wounds (n = 11) and skin tears (n = 7). Normal rates of wound healing (>10% per week) were observed in the majority of patients (36/50, 72%) over their duration of treatment. Complete healing during the study period was observed in 43% of venous leg ulcers, 55% of traumatic wounds, 71% of skin tears, and 80% of other wound types. No adverse effects of TPD administration were observed. Treatment with TPD resulted in significant reductions in wound area of nearly all wounds, regardless of etiology.
Massive Localized Lymphedema, Wound Care Without Major Surgical Excision: A Case Report
Authors: Heuvelings Danique J. I. , van der Horst Jishmaël , Pelzer Fanny , Aarts Frits , Engelen Sanne
Published: November 2024

Massive localized lymphedema (MLL) is a benign overgrowth of lymphoproliferative tissue that is primarily observed in adults with class III obesity. Patients present with a painless mass that has usually been present for a considerable period. Consultation of a healthcare professional typically takes place when MLL-related complaints interfere with daily living. Massive localized lymphedema is often termed “pseudosarcoma” due to its clinical similarity to sarcoma. Surgical excision is necessary to improve mobility, prevent recurrent infections, and rule out malignancy, but can be high-risk for individuals with class III obesity and multiple comorbidities. In this report, the authors present the case of a 47-year-old woman with a body mass index of 73 kg/m2 and MLL of the right medial thigh. She was successfully diagnosed and managed by local necrosectomy, wound debridement, maggot debridement therapy, and negative-pressure wound therapy by using a vacuum-assisted closure device. The diagnosis of MLL can be challenging because of its similarity to sarcoma; its pathogenesis and management are not completely elucidated. Despite surgery being the best described treatment, such an intervention itself can be challenging because patients often have multiple comorbidities and delayed diagnosis. The authors recommend that clinicians should consider nonsurgical treatment of MLL in high-risk patients who have necrotic wounds with fluid loss. The use of less invasive methods such as maggot debridement therapy followed by negative-pressure wound therapy can be useful in high-risk patients.