bluuebunny/crossref_metadata_2025 huggingface dataset:
E- Selectin as a Predictor for Overt and Subclinical Cardiovascular Riskin Patients with Juvenile Idiopathic Arthritis
Authors: Fatah Ibrahim Magid Ashraf Abdel , Mostafa Gehan Ahmed , Shousha Ghada Abdel Haleem , Fatah Mohamed Roshdy Ola Mohamed Abdel , Hameed Abeer Maghawry Abdel , Ghani Amani Mohamed Abdel , Elsayed Eman Mohamed
Published: November 2024

Background

The risk of cardiovascular disorders (CVD) was described in adult patients with systemic juvenile idiopathic arthritis (SJIA) as a part of the systemic activity of the disease. Subclinical cardiovascular risk and early atherogenesis were not broadly studied in children.

Objectives

This work aims to evaluate soluble E-selectin level as a marker of early endothelial injury, as a predictor for early or subclinical CVD among patients with juvenile idiopathic arthritis (JIA).

Patients and Methods

This cross-sectional study with nested follow up was conducted in the Pediatric Allergy, Immunology and Rheumatology Unit, Children’s Hospital, Ain Shams University on 57 children and adolescents diagnosed as JIA. They were 6 to 16 years old, including 26/57 (45.6%) males and 31/57 (54.4%) females, and 30 matched healthy controls, during the period from September 2021 to September 2022. Patients were enrolled consecutively during activity and remission status of the disease, determined according to juvenile arthritis disease activity score (JADAS). Serum level of endothelium (E)-selectin was measured using ELISA technique. Patients with active JIA were followed till complete remission.

Results

Serum levels of E-selectin showed higher estimates among JIA patients during activity and remission than in the healthy control group (p < 0.001); whereas there was no significant difference in E-selectin level among the studied categories of JIA (P > 0.05).

Conclusion

The observed significantly elevated soluble E-selectin levels among pediatric patients with JIA, denotes the possibility of early atherogenesis or subclinical CVD. Correlation with other cardiac evaluation tools in patients with JIA is recommended.
The Effect of Iron Therapy on Plasma Ghrelin and Leptin Levels in Egyptian Children with Iron Deficiency Anemia
Authors: Mahmoud Gad EL Hak Radwa Gad EL Hak , Emam Ehab K , Abdo El Gendy Yasmin Gamal , Shaaban Menna Allah Ali , Mohammed Basma Abd El Nasser
Published: November 2024

Background

Iron deficiency (ID) is the most common micronutrient deficiency and the most common cause of anemia worldwide. It is known that iron deficiency anemia effects appetite and growth negatively. The aim of this study was to investigate the effect of iron therapy on appetite and plasma ghrelin and leptin levels in children with nutritional iron deficiency anemia.

Methods

A prospective interventional study was done on 40 iron deficient pediatric patients diagnosed by CBC and Iron profile aged between 12 to 60 months. All 40 cases were given oral iron therapy (5mg/kg). Anthropometric measures and appetite score subjectively by mother were done before and after iron therapy. Caloric intake was calculated specially protein, Fat and CHO before and after treatment. Serum Ghrelin and Leptin done by ELISA Kit ;Specimen Collected whether Serum or plasma.

Results

The median rang (IQR) plasma ghrelin level was 1 (0.9 - 1.25) mg/mL before therapy and it increased to 3.6 (2.65 – 4.8) mg/mL (p < 0.001) while the median plasma leptin level decreased from 2.05 (1.4 – 3.2) ng/mL to 0.41 (0.3 – 0.65) ng/mL (p < 0.01) after therapy. The amount of daily caloric intake, carbohydrate and protein intake were significantly increased after therapy (p < 0.001). Body weight was correlated with plasma ghrelin levels before and after therapy significantly. There was a positive correlation for Ghrelin with TIBC and UIBC (r = 0.387, p-value = 0.014) (r = 0.388, p-value = 0.033) respectively.

Conclusions

In conclusion, the findings of our study indicate that plasma ghrelin level increases and leptin level decreases in children with iron deficiency anemia after iron therapy. The increase in appetite and improvement of growth in iron deficiency anemia might result from decreased leptin and increased plasma ghrelin levels after treatment.
Impact of Digital Media on ADHD Patients during COVID 19 Quarantine (Pandemic)
Authors: Youssef Azza Mohammed , Othman Abo AL–Ola Radwa Mohammed , Elhamid Salwa Amin Abd
Published: November 2024

Background

The COVID-19 pandemic & quarantine cause increased media usage along with positive and negative life style changes under lockdown for all children especially those with attention deficit hyperactivity disorder (ADHD) as they are already at higher risk to have more psychological and behavioural problems.

Objectives

To assess the effect of digital media on emotional state and family environment of the children and adolescents with ADHD during pandemic and quarantine.

Patients and Methods

Observational cross-sectional study was conducted on 200 participants recruited from (patients from developmental and behavioral clinic and controls from other pediatrics outpatient clinics). They were divided into; 100 ADHD (43 cases with problematic digital media use (PDMU) and 57 cases without PDMU and control group (n = 100)). Detailed history was taken including sociodemographic data, age, sex, total hours of using media and total hours of activity per week The following scales had been evaluated: Self- rating questionnaire for problematic mobile phone use: which estimate the dependence symptoms of mobile phone use (which used to classify patients to ADHD with and without PDMU and control group according to its score), Revised Child Anxiety and Depression Scales and Difficulties in Emotion Regulation Scale–Short Form.

Results

The study showed that ADHD group with PDMU had significantly increased in total hours of watching media as well as lower activity (p < 0.001) when compared to ADHD without PDMU and control group. Also, ADHD children showed higher Anxiety and depression scores when compared to control group while non-significant differences were observed between ADHD children with PDMU, when compared to ADHD children without PDMU (p < 0.001). ADHD children with PDMU showed significantly less ability to control their emotions followed by ADHD children without PDMU then control group (p < 0.001).

Conclusion

The digital media use during COVID19 pandemic and quarantine, was affecting ADHD children with PDMU negatively more than ADHD without PDMU then those without ADHD as regard their regulation of emotions, total hours of using media, anxiety and depression scores.
Evaluation of Serum Interleukins 17A and 22 Levels in Pediatric Patients with Autism
Authors: Mostafa Gehan Ahmed , Hossiny Reham Mohammed El , Abdelfattah Sara Ibrahim , Sabry Shaker Youstina , Sallam Dina Ebrahem Darweish
Published: November 2024

Background

The etiology of autism has emerged as a topic of serious debate in recent years, where autoantibodies may play a role. IL-17A is a key regulator of Autism spectrum disorder development, while interleukin (IL)-22 is a potent mediator of inflammatory responses promoting leukocyte infiltration in the brain.

Objective

To assess serum levels of IL-17A and IL-22 in children with autism.

Methods

A cross-sectional study, that was carried out at Child Psychiatric Clinic, Ain Shams University, Cairo, Egypt on autistic children and healthy controls.

Results

we had 48 subjects, 24 autistic children; 6 females (25%) 18 males (75%) and 24 age and gender matched controls; 9 females (37.5%) 15 males (62.5). The median (IQR) age was 5.25(5 – 8) and 6(5 – 9) years respectively. The median serum levels of IL-17A and IL-22 were significantly higher in autism patients than controls, where serum level of IL-17 was 262.5 (235 – 320) pg/mL in autistic patients versus 35 (25 – 47.5) pg/mL in controls, meanwhile IL-22 in autistic patient was 800 (680 – 975) pg/mL versus 50 (45 – 65) pg/mL in controls (p = <0.001).

Conclusion

In our cases, a Shaimaa Abdo Elmetwaly Shaimaa Abdo Elmetwaly Shaimaa Abdo Elmetwaly utism was associated with elevated serum levels of IL_17A and IL-22. We can't point out whether it is a cause, an effect or a mere association. Further research is needed for better understanding the role of these cytokines in autism and their potential implications for diagnosis and treatment.
Assessment of Infection Prevention and Control Measures in Pediatric Hematology Oncology Unit, Ain Shams University
Authors: Mohamed Wafaa Ezzat Ibrahim , El-Tonbary Khadiga Yehia , Fahmy Monica Ashraf Samy
Published: November 2024

Background

There are various factors which contribute to the increased susceptibility to infections in Pediatric Hematology/Oncology (PHO) patients, most prominent of them being disruption of cutaneous and mucosal barriers (oral, gastrointestinal, etc.), microbial gastrointestinal translocation, defects in cell-mediated immunity, and insufficient quantities and inadequate function of phagocytes.

Aim of the Work

This study aimed to assess the currently applied infection prevention and control (IPC) measures among Pediatric Oncology and Hematology patients admitted to the inpatient unit and to explore areas of improvement of IPC measures to improve the overall outcome of such patients.

Patients and Methods

This cross-sectional observational study was conducted at the Hematology and Oncology unit, Children's Hospital at Ain Shams University from April 2023 to September 2023. It assessed the IPC measures in the inpatient ward and the measures applied to the 100 admitted, patients in addition to reported infectious complications. The study also assessed the practices and vaccination status of the health care professionals(HCP).

Results

A total of 100 patients were included, hematological (including lymphomas)malignancies dominated with 72%, solid and CNS tumors represented 20% and the aplastic anemia patients represented 8%. The majority were admitted 77% for chemotherapy. Thirty-one febrile neutropenia episodes were reported. As regards the patient care practices, all patients followed a neutropenic diet as per hospital policy, no guidelines were available for drinking water, tap water was supplied through hospital tanks. Oral and dental care was strictly followed in 36% of patients during admission and only 2% had pre-chemotherapy dental assessment. Regarding other IP measures, strict guidelines were followed during central lines, venous access or indwelling catheter application. HCP vaccination status was defective in annual flu vaccine, however all were fully vaccinated with hepatitis B and COVID vaccines. Mucositis was reported in 45 % and was significantly correlated with sepsis-related mortality. Among the laboratory confirmed bloodstream infection (LCBI) staphylococcus aureus and staph coagulase negative dominated while in the reported central line- associated bloodstream infection (CLABSI)(15%), klebsiella was the commonest organism.

Conclusion

Staphylococcal infection and klebsiella were the commonest pathogens in the PHO ward. Though strict sterile measures were followed, still Staph coagulase was a common pathogen in CLABSI. Mucositis andmucosal barrier injury (MBI) is a significant risk for microbial translocation and morbidity. Dental care, water supply and healthcare professionals’ immunizations are important areas to improve in order to improve the PHO ward.
Early Detection of Arteriovenous Fistula Problems among Pediatric Hemodialysis Patients
Authors: Elhakim Ihab Z , Elsayed Reham G , El-Azim Tarek A Adel Abd , Hetta Walid M , Darwish Yasser W , Sallam Dina E
Published: November 2024

Background

End stage Kidney disease (ESKD) is a major problem that is related to development of inflammation. Establishment of vascular access (VA) in the form of arteriovenous fistula (AVF) is mandatory to conduct efficient hemodialysis (HD). VA complications are one of the main causes of increase in morbidity and mortality in ESKD patients, which needs to be monitored regularly.

Objective

to evaluate the value of duplex ultrasound (DUS) and inflammatory markers (high sensitivity (hs) CRP, IL10, TNF) in early detection of vascular access complications in pediatric ESKD patients on regular HD.

Methods

This observational and interventional study was carried on 59 pediatric patients on regular HD at the PediatricDialysis Unit, Children’s Hospital, Ain Shams University, where DUS and serum level of inflammatory markers (hs-CRP, IL10, and TNF) were assessed once at time of enrollment (1) and the second at the time of early clinical suspicion of VA complication (2) which was detected by any abnormalities in physical examination.

Results

The study comprised 59 pediatric patients on regular HD, their mean (± SD) age was 13.97 (±2.65) years, 39 (56.5%) of them were males. The most common etiology of CKD was congenital anomalies of kidney and urinary track (CAKUT). Complications of the VA were reported in 55.9% of our studied patients, which include thrombosis, aneurysm, stenosis, early VA failure, pseudoaneurysm and perivascular hematoma, where thrombosis was the most frequent (28.8%), and was confirmed by DUS. AVF diameter (2), and flow volume (2) were significantly lower among patients with AVF thrombosis. The mean serum level of hs CRP was significantly elevated at the time of early clinical suspicion of AVF stenosis, and was confirmed by DUS, in comparison to its baseline level at time of enrollment of the study (0.08±0.08, 0.16±0.28 ng/mL, respectively, p = 0.04), serum IL10(1&2) and TNF (2) were higher in this group. Early VA failure were reported in patients who had lower AVF diameter (1), PSV (1), EDV(1&2),flow volume (1&2), and higher AVF diameter (2), PSV (2).

Conclusion

DUS and hs-CRP are useful tools for early detection and, hence the management of AVF complications.
Melatonin Attenuates Diclofenac Induced Renal Injury in Aged Rats via Modulating mRNA Expression of miR-34a, Nrf2/HO-1, ENaC and Suppressing NLRP3 Inflammasome Activation
Authors: Agaty Sahar M El , Darwish Doaa A , Diaa Sherif M , Metwally Doaa K , Wanis Nardine A
Published: November 2024

Background

High doses of diclofenac (DF) might induce acute kidney injury (AKI), particularly in elderly, a known vulnerable population. Melatonin was found to afford a beneficial effect in various kidney diseases.

Aim

To investigate the possible nephroprotective effect of melatonin in aged rats subjected to AKI by DF, and to highlight the implicated mechanisms.

Design

Experimental study

Methods

Thirty male Wister rats, aged 22-24 month, were equally divided into: control group, DF treated group (DF-group), and melatonin and DF treated group (Mel-DF-group).

Results

Melatonin significantly attenuated plasma creatinine, and urea along with decreased renal malondialdehyde and NADPH-oxidase-4 in Mel-DF-group versus DF-group. This was associated with a significant decrease in renal levels NLRP3 (NLR family-pyrin domain containing-3) inflammasome, Toll-like receptor-4, nuclear factor kappa (NF-κB), caspase-1, renal mRNA expression of microRNA-34a (miR-34a), and renal expression of tumor necrosis factor-alpha. The renal reduced glutathione (GSH), nuclear factor erythroid-2-related factor-2 (Nrf2), and hemoxygenase-1 (HO-1) were significantly increased in Mel-DF-group versus DF- group. Also, melatonin significantly reduced DF-induced hypernatremia together with significant decrease in renal epithelial sodium channels (ENaC) expression. Histopathological examination showed a significant decrease in vascular congestion, mononuclear cells infiltration, glomerular and tubular damage scores in Mel-DF-group-versus DF-group, besides a significant decrease in area % of collagen fibers deposition.

Conclusions

Melatonin provides a nephroprotective effect against DF-induced AKI in aged rats via attenuating renal oxidative stress, miR-34a, and NLRP3 inflammasome activation, which further increased renal Nrf2/HO-1 and GSH and inhibited fibrosis. Also, melatonin alleviated DF-induced hypernatremia via decreasing the ENaC renal expression.
Evaluation of Screw and Wire Traction in Anatomic Reduction of Mandibular Fracture
Authors: Hussein Mohamed Ibrahim , Mahmoud Nada Abdelsattar , Reyad Khaled , salah Lina
Published: November 2024

Background

Displaced mandibular fractures have numerous ways of being reduced, the aim of adequate fracture reduction is to achieve good bone contact to allow for adequate healing. Reduction techniques include, bone holding forceps, manual reduction and reduction using IMF techniques which restore occlusion and then secondarily reduce the fracture site. Fracture immobilization using rigid fixation then follows reduction thus maintaining adequate bone contact allowing fracture line healing. The use of screw and wire traction provides stable fracture reduction anatomically without the need for IMF.

Aim of the Work

The aim of this study is to evaluate the efficacy of screw and wire traction in anatomical reduction of mandibular fracture on the accuracy of reduction, operative time and post-operative pain and edema.

Patients and Methods

This is a single arm interventional clinical trial including twenty adult individuals with mandibular fractures. Patients who are fulfilling the inclusion criteria of our study were sampled randomly.

Results

Twenty cases were included in our study. Adequate fracture reduction was done in all patients with good clinical bone contact and with good post-operative CT results, post-operative pain and edema were minimal due to decreased manipulation of the fracture and the simplicity of the technique. The occlusion of the patients was followed up 2 and 6 weeks post operatively with cases showing no occlusal disturbance and return to normal function within 3 months.

Conclusion

Screw and wire traction for reduction of mandibular fractures anatomically showed success as regards to fracture reduction and showed no occlusal complication, we recommend this technique specially in symphyseal, paranymphs and angle fracture. The fracture line taking a strictly vertical axis shows the best outcome, however multiplanar fracture lines or L-shaped fractures are not good specimens for this method of reduction.
Association between the Frequency of Social Media Exposure and Mental Health Problems among Employees at Ain Shams University during the COVID-19 Pandemic
Authors: Nagi Mariam wadi Abdulla , El-Awady Mohamed Yehia , Magdy Isis , Shehata Mossad , Wassif Ghada O
Published: November 2024

Background

The COVID-19 pandemic created a threat to human well-being. The rapid spread of the coronavirus disease combined with quarantine measurements made people use social media platforms more than before. The improper and excessive use of social media affected people’s mental health, resulting in increased levels of depression and anxiety.

Objective

This study aimed To measure the frequency of anxiety and depression in the last 12 months, during the COVID-19 pandemic among employees at Ain Shams University. And to measure the association between social media exposure and mental health, including anxiety and depression among employees at Ain Shams University in the last 12 months, during the Covid- 19 pandemic.

Method

Data was gathered through a 6- month cross-sectional analytical study including 405 staff members who were asked to answer a standardized self-administered questionnaire from 1 September 2021 to 31 March 2022. The questionnaires contain three parts: (1) socio- demographic information (2) Daily use of social media and other types of media (3) Measurement of levels of anxiety and depression using the GAD-7 and PHQ-9 scales

Result

Overall 405 participants were enrolled, 203 males and 202 females ranging from the age (20-30) to 51 and above. (78.8%) of the study sample used social media to be updated about the pandemic. (40.7%) and (41.6%) of the participants who visited social media six times or more per day scored severely depressed on the PHQ-9 scale and severely anxious on the GAD-7 scale, respectively. Furthermore, (33.1%) of participants who used social media for 4 hours or more had severe depression according to the PHQ- 9, and (29.9%) had severe anxiety according to the GAD-7.

Conclusion and Recommendations

Our findings offer some evidence for a troubling relationship between COVID-19-related media exposure on social media and psychological problems, and therefore understanding these problems can help to prevent them in future crises. Additionally, it could help governments monitor the spread of misinformation.
Personal Listening Devices (PLDs) Usage and Auditory Effects among University Students in Egypt: A Cross-Sectional Study
Authors: Raouf Nabila Mohammed , Salah Waleed , Moharram Ghada , Hussein Wafaa Mohamed , Mahaba Hisham
Published: November 2024

Background

The improper use of personal listening devices (PLDs) among young adults has been associated with an increased risk of hearing loss.

Objectives

This study aimed to investigate the PLDs listening practices among university students and to assess their auditory effects.

Methods

A cross-sectional study was conducted, involving a sample of 310 university students from Ain Shams University. The participants were conveniently selected from the Faculty of Medicine and Science. Participants were surveyed about their PLDs listening practices, including the daily duration of PLDs use, the volume at which they were typically used, and the number of years they had been using their PLDs. Participants were asked about common hearing problems associated with PLDs, and other risk factors for hearing loss were assessed. Hearing loss screening was done using the Five-minute hearing test (FMHT) and the “Hear WHO” mobile application. Participants who tested positive for hearing loss by both tests were referred for diagnostic pure-tone audiometry (PTA).

Results

Approximately 69% of the students used PLDs with an in-earpiece mainly during studying. A considerable proportion of students (53%) stated that they had been using their PLDs for over 5 years. Moreover, a notable percentage of students reported extended usage, with 83% using their PLDs for more than 60 minutes per day, and 72% using them at a volume level above 6. The majority of students (74%) were classified as low-risk users in terms of PLDs use. Thirty-three (10.6%) students tested positive for hearing loss on both screening tests, but only 5 (1.6%) had confirmed hearing loss by PTA. A Shift in the average hearing threshold at 4 kHz was detected in both ears, while remained within the normal range. Tinnitus was the most common symptom reported by 151 (49%) of the students, followed by ear pain reported by 130 (42%) of them. It was also detected that there was no statistically significant difference in hearing threshold levels based on the duration of PLDs use or the risk status of PLDs use. Moreover, in the multivariable logistic regression analysis, it was found that risk category of PLDs use was a significant predictor of tinnitus (OR: 2.69; 95% CI, 1.46-4.65), ear pain (OR: 2.62; 95% CI, 1.70-4.80), and excessive ear wax (OR: 2.43; 95% CI, 1.30-4.20) in higher risk categories compared to lower risk group.

Conclusion

Most students used PLDs for more than one hour daily with high volume (> 6). PLDs use was associated with auditory problems including tinnitus and ear pain. Regular hearing screenings is recommended for early detection of hearing loss among PLDs users.
Role of Transcranial Doppler Ultrasound in Early Assessment of Acute Post Traumatic Brain Injury
Authors: Ekbal Ghoneim Ahmed Mohamed , Mohamed Safaa Kamal , Hetta Waleed Abd el Hamid , Alsayed Alkaphoury Mona Gamalludin
Published: November 2024

Introduction

Traumatic brain injury (TBI) is a global health and socioeconomic problem. It is responsible of millions of ED visits, hospitalizations, and deaths with lifelong disability among survivors. Immediately after TBI, cerebral blood flow (CBF) is extremely low approaching the ischemic thresholds. Concurrently, CBF velocities become strongly correlated to CBF itself. Identification of such disturbances can predict outcome in TBI when assessed early post- injury using Transcranial Doppler (TCD). TCD provides non-invasive real time measurements of CBF velocities as well as pulsatility index (PI).

Design

Observational prospective cohort study.

Setting

Helwan university hospital.

Aim

to assess the accuracy of transcranial Doppler ultrasound as an early predictor of secondary neurological deterioration after acute post traumatic brain injury

Patients and Methods

55 patients of acute post traumatic brain injury underwent TCD within 8 hours post trauma. Middle cerebral artery (MCA) velocities and pulsatility index, as well as GCS and initial CT findings, were recorded. The primary end point was the development of secondary neurological deterioration (SND) at day 7 after injury. Secondary outcome measures were the in-hospital mortality and hospital length of stay.

Results

There was a significant relation between end diastolic velocity (EVD) as well as PI with SND at day 7 as well as GOSE at day 28 post-trauma. There was also significant correlation between PI and hospital mortality.

Conclusion

TCD, when done early after admission, is useful in identifying patients at risk for developing neurological deterioration after TBI. EDV and PI are good predictors of SND at one week.as well as in-hospital mortality.
Value of Strain Elastography in Evaluation of Supraspinatus Tendinopathy in Patients with Chronic Shoulder Pain, A Comparative Study to MRI
Authors: Samir Abdelmohsen Ahmed Mohamed , Fahmy Marwa Ibrahim , Ashraf Okba Ahmed
Published: November 2024

Background

Rotator cuff disorders are one of the most important causes of chronic shoulder pain and the clinical differentiation between the different rotator cuff disorders is difficult and imaging is mandatory for diagnosis and proper assessment of rotator cuff abnormalities. The most commonly used imaging modalities are ultrasonography (US) and magnetic resonance imaging (MRI) with MRI is the reference standard for imaging of rotator cuff disorders yet its use is hindered by high cost and MRI contraindications.

Aim of the Work

to assess role of SEL in the evaluation of supraspinatus tendon abnormalities and to evaluate the relationship between the measured strain ratio and the MRI grade of tendinopathy.

Patients and Methods

Our study included 40 patients with chronic shoulder pain including 11 patients with no evident tendinopathy on MRI (grade 0) (27.5%) 9 patients with grade I tendinopathy (22.5 %), 10 patients with grade II tendinopathy (25 %) and 10 patients (25 %) with supraspinatus tendon tear (grade III).

Results

Our study showed that normal supraspinatus tendons appear homogenous and stiff with high strain ratios, whereas pathological ones showed a more heterogenous and reduced stiffness pattern with intratendinous color alterations and lower strain ratios. This is explained by the fact that tendinopathy leads to collagen fiber degeneration and breaking down, resulting into tendon softening and weakness. Our study also showed strong linear association between the MRI grade and the stiffness indicated by the strain ratios (p < 0.05). There was a perfect negative correlation grade of tendinopathy and SEL strain ratio. As tendinopathy increased, tendons became softer which was indicated by the reduced strain ratio values. These findings were in agreement with many previously published studies.

Conclusion

The application of SEL in musculoskeletal system is not well established, but this study showed that SEL can detect differences between the normal and diseased rotator cuff tendons with good correlation to MRI with other studies showed improved sensitivity, specificity and accuracy in detection of tendon abnormalities. It can also add further important information to conventional shoulder imaging such as tendon quality which considered as a prognostic factor for rotator cuff repair.
Transabdominal Ultrasound Imaging of Pelvic Floor Muscle Activity in Women with Stress Urinary Incontinence
Authors: Sobhy Guirguis Mounir , Ibraheem Suzan Farouk , Abdallah Alaa Abdelkhaleck
Published: November 2024

Background

Several methods are used in assessment of pelvic floor muscles (PFM) in female patients with stress urinary incontinence (SUI). Transabdominal ultrasound (TAU) is an easy, inexpensive, and non-invasive assessment tool that has been used to evaluate aspects of PFM function. Bladder base displacement, which is detected by TAU, is considered a marker for PFM activity.

Objective

Detection of the role of transabdominal ultra sound in evaluating pelvic floor muscle activity in women with stress urinary incontinence.

Patients and Methods

A total of 42 female volunteers (half patients were volunteers from friends, neighbors, colleges and relatives with no stress urinary incontinence, the another half was clinically diagnosed as stress urinary incontinence considering age matching between volunteers and patients with stress urinary incontinence. The medical charts of ultrasound of forty two consecutive females were analyzed. The US examinations were performed using adapted equipment with high-resolution curvilinear transducers. The difference in bladder base displacement (as the dependent variable) between the resting position and the end of each maneuver was measured in millimeters. Three tasks were performed in random order; PFM contraction, Valsalva maneuver, and abdominal curl. Supervisors and experts interpreted the images of the examinations.

Results

Higher mean values of bladder base decent were reported during Valsalva maneuver, PFM contraction and abdominal curl among cases women with stress urinary incontinence compared with control cases. There was no difference between study groups regarding age, parity and mode of delivery.

Conclusion

PFM performance is decreased in women with urinary incontinence. Transabdominal ultrasound is safe, accurate, noninvasive and safe tool in evaluating pelvic floor muscle activity in women with stress urinary incontinence.
Role of Ultrasound Elastography versus Ultrasound Guided Biopsy in Detection of Cancer Prostate
Authors: Remah Ali Ahmed , Abdel Raouf Maha Mohamed , Ghandour Ahmed Mohamed , El Diasty Shaimaa El Metwally
Published: November 2024

Background

Prostate cancer detection has evidently evolved through the past years. Ultrasound is already established in PCA diagnosis, with introduction of adjuvant techniques to ultrasonography promoting its capabilities in PCA diagnosis. Elastography technique was introduced for the first time in the 90s, it is an easy procedure with high capabilities in diagnosis and can be at same session with US increasing its specificity.

Aim of the Work

The aim of this study is to define the effect of US elastography in early detection of cancer prostate.

Patients and Methods

This study was prospectively carried on 22 male patients having prostatic lesions, (between June 2020 to November 2022), the mean age of all cases was 63.5 years, with a median of PSA of 30.6 ng/mL, a median prostatic volume of 65 mL. This study was performed in the ultrasound unit/ radiology department of the Police Medical Complex at New-Cairo. Patients were referred from the outpatient clinic of the urology department.

Results

We found that to differentiate between benign and malignant lesions the best stiffness cut-off value would be between 35 and 37 kPa, sensitivity 83.3%, specificity 70%, PPV 76.9% and NPV 77.7% and accuracy 77.2%.

Conclusion

Elastography is an easy procedure that provides diagnostic extra tool which can be easily done in the same session with the B-mode ultrasound examination and improves its specificity for detection of prostatic cancer. It has proven benefit in differentiating benign form malignant lesions and optimizing the results of prostate biopsies.
Comparison Study between MRI with Contrast and Doppler Ultrasound in Diagnosis Pathological Nipple Discharge
Authors: Abdelbary Aliaa Maamoun , Mohammed Safaa Kamal , Salama Asmaa Magdy Mohammed
Published: November 2024

Background

Pathologic nipple discharge (PND) is characterized by spontaneous secretions that stem from unilateral single or several ducts. The most common cause of nipple discharge is benign breast lesions, such as solitary intraductal (ID) papilloma and papillomatosis. A rare but major cause of PND is breast cancer, which comprises 5%-21% of such cases.

Aim of the Work

In this study we aimed to compare the accuracy of Contrast-Enhanced Magnetic Resonance Imaging (CEMRI) and Doppler ultrasonography in patients with pathological nipple discharge using pathological examination as a golden standard.

Patients and Methods

This cross sectional study was conducted in Mit - Ghamer Oncology Center and Ain Shams university Hospitals. We enrolled 50 female patients their mean age (SD) was 44.44 years & ranged between (17-73) years.

Results

There was statistically significant difference between malignant and benign lesions regarding Doppler findings as benign lesions more liable to appear as avascular (84.62%) and hypovascular (61.11%) than malignant lesions; on the other hand malignant lesions appeared mainly as intermediate (91.67%) or hypervascular (85.71%). There was statistically significant difference between benign and malignant lesions regarding vascular flow Pattern; as avascular pattern appeared mainly in benign lesions (84.62%), However, penetrating (57.14%) as well as peripheral and penetrating (83.33%) pattern appeared mainly in malignant lesions. Doppler US showing accuracy 80%, sensitivity 84.6% and specificity 75%. Regarding MRI findings, homogenous enhancement was statistically significant as main finding of all benign lesions (100%). Also, heterogeneous enhancement was significantly significant among malignant (92.86%) lesions. Regarding curve type, there was statistically significant difference between benign and malignant lesions as type I curve was represented mainly benign lesions (93.33%), type III curve was represented malignant lesions (100%) and type II curve was represented in 10 benign cases (71.43%) and in 4 malignant cases (28.57%). Regarding MRI it had a higher accuracy (88%), sensitivity (88.5%) and specificity (87.5%) than Doppler.

Conclusion

Contrast enhanced MRI is superior to Doppler US in the diagnosis of PND. Contrast enhanced MRI has higher sensitivity, specificity and accuracy (88.5%, 87.5% and 88%) respectively than Doppler US (84.6%, 75% and 80%) respectively.
Adhesive Capsulitis of the Shoulder Joint; Correlation between the Utrasonographic and MRI Findings
Authors: farouk Kamel Omar , Eladly Alshaimaa Mohamed , Ahmed Khaled Sayed
Published: November 2024

Background

Adhesive capsulitis “frozen shoulder,” is a debilitating condition characterized by progressive pain and limited range of motion of the glenohumeral joint. It is a condition that typically affects middle-aged women, with some evidence for an association with endocrinological, rheumatological, and autoimmune disease states. Early diagnosis and treatment of adhesive capsulitis can lead to markedly improved clinical management. Diagnosis is usually based on physical examination alone. However, imaging studies can clarify the diagnosis in equivocal cases showing overlapping symptoms with other shoulder pathologies.

Aim

to correlate between the ultrasonographic and magnetic resonance imaging (MRI) features of adhesive capsulitis of the shoulder (ACS).

Material & Method

Our study was carried out on 30 patients, of any age group, having shoulder pain and stiffness for longer than 15 weeks. The patients had both US & MRI examinations, the findings of the 2 modalities were recorded and compared.

Results

There was significant statistical agreement (P value <0.001) between US & conventional MRI, US demonstrated CHL, IGH and rotator interval changes.

Conclusion

Based on the results, high resolution US with dynamic real-time assessment was proven to be sensitive, specific with significant agreement to conventional MRI in detecting adhesive capsulitis pathology. So US can be used as an initial modality for patients with chronic shoulder pain and limitation of movements.
Comparison of the Retention and Aspiration Techniques in Ultrasound-Guided Ethanol Ablation of Thyroid Cystic Nodules
Authors: Abdo Salem Amr Muhammad , Abou-Elmaaty Mohamed El-Gharib , Abdelsalam Mona Mohamed , Abdelmoteleb Mohamed Gamal , Allam Allam El-Sayed
Published: November 2024

Background

Ethanol ablation (EA) is the first-line of therapy for relapsing symptomatic cystic thyroid nodules in most guidelines; however there is no consensus regarding the procedure details. Two techniques have been described for EA of thyroid cystic nodules; the retention technique and the aspiration technique. There are conflicting data regarding the superiority of one technique over the other.

Aim of the Work

to compare between the retention technique and the aspiration technique in treating cystic and predominantly cystic thyroid nodules.

Patients and Methods

20 patients with mean age of 35.3±15.2 years having thyroid cysts or predominantly cystic nodules were treated using ethanol ablation. 10 patients were treated using retention technique, the other 10 patients were treated using aspiration technique.

Results

15 patients (75%) were females, while 5 patients (25%) were males. Pure cystic nodules were 9 (45%), while 11 (55 %) patients had predominantly cystic nodules. The median nodule initial volume was 26 cc (14.23-38.45). The 6 month VRR was 81% (60-88), with overall success rate (VRR≥ 50%) of 85 %. No statistically significant difference was found between the retention and aspiration techniques as regards the 6-month VRR (P = 0.62), success rate (P = 0.76), symptom score (P = 0.63), cosmetic score (P = 0.455), or procedural pain (P = 0.43).

Conclusion

Retention and aspiration techniques show the same efficacy and safety in treating pure cystic and predominantly cystic thyroid nodules.
Effect of Transarterial Chemoembolization on Portal Venous Pressure in Patients with Hepatocellular Carcinoma
Authors: Abo-Elmaaty Mohamed El-Gharieb , Saad Heba Ismail , Shokry Wessam Sherin , Mahmoud Amr Salah Ahmed
Published: November 2024

Background

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and has a poor prognosis unless treated. Transarterial chemoembolization of HCC lesions is a promising treatment option for patients who are not eligible for surgery.

Objective

To study the short term effect of TACE on portal venous pressure by assessing it indirectly through measuring hepatic venous pressure gradient before and after TACE procedure.

Patients and Methods

Our study was a Prospective cohort analysis of patients who were been referred to our IR unit (in our university hospital) diagnosed with HCC for performance of TACE at the period between January 2022 and December 2022. (21 patients).

Results

Our study showed that there is no short term effect of TACE on HVPG (which reflects the portal pressure). We also recommend doing a follow up measurement of HVPG after 6 months and compare it with the baseline measurements to assess the long term effect of TACE on the portal pressure.

Conclusion

Our study is in agreement with previous studies that there is no short term effect of TACE on HVPG (which reflects the portal pressure).
Impact of Artificial Intelligence on Accuracy and Reading Time in Breast Mammogram Interpretation
Authors: Elsayed Fahmy Aya Elsayed Kamel , Ahmed Aya Yassin , Abdulhafiz Essam Mohamed
Published: November 2024

Background

Breast cancer is the second leading cause of death from cancer in women Bray, but early detection and treatment can considerably improve outcomes. As a consequence, many developed nations have implemented large-scale mammography screening programmes.

Aim of the Work

to evaluate the impact of artificial intelligence on reading time and accuracy in breast mammogram interpretation.

Patients and Methods

This study is carried as retrospective comparative study 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 mammography from august 2022 to October 2023.

Results

the most experienced radiologist had the highest accuracy, sensitivity and specificity (97.5%, 95% and 100% respectively). The next 2 radiologists had comparatively lower overall accuracy (92.5% and 92.5% for radiologist 2 and 3), with the more experienced of them showing higher specificity and lower sensitivity figures than the less experienced (100% Versus 95% for specificity and 85% Versus 90% for sensitivity). On the other hand, the AI was inferior to the most experienced radiologist for sensitivity and overall accuracy figures and showed equal specificity whereas it showed non inferior figures to the next 2 radiologists demonstrating relatively higher sensitivity and overall accuracy figures compared to both radiologists.

Conclusion

We found that the AI accuracy has been proven to be comparable to the radiologist 1 (highest years of experience) with equal specificity and lower sensitivity, and not inferior and even higher than radiologist 2 and 3 (medium and low years of experience). The reading time of the AI software was much less than the three radiologists. The highest agreement of the AI software was with the radiologist 1 (the most experienced).
The Added Role of Kaiser Score in Evaluating BIRADS 4 Breast Lesions in Breast MRI
Authors: Saady Basma Ahmed , Osman Noha Mohammad , Awad-Allah Shrouk Mohammad
Published: November 2024

Background

Breast malignancy is one of the most common malignancies affecting women, representing 31% of overall tumors affecting the females around the world. The increase in breast cancer incidence is accompanied by an increase in the clinician and researchers concerns regarding the improvement of diagnostic and therapeutic tools. Dynamic contrast- enhanced magnetic resonance imaging (MRI) is one of the most sensitive breast imaging modalities, but it has a relatively low specificity. Breast MRI findings are evaluated using the standardized American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) lexicon, which uses multiple descriptors to characterize enhancing lesions. Kaiser score is a simple flowchart that includes five major diagnostic criteria (root sign, dynamic enhancement curve type, margins, internal enhancement pattern, and edema) and its diagnostic accuracy is high.

Aim of the Work

The study aims to evaluate the added role of Kaiser score in score in evaluating BIRADS 4 breast lesions in breast MRI.

Patients and Methods

This is a retrospective study included 22 female patients who were diagnosed with breast lesions categorized as BIRADS 4, using the Kaiser score, where the Kaiser score threshold for malignancy is ≤ 4.

Results

The study investigated the diagnostic performance of Kaiser score in BIRADS 4 breast lesions. Kaiser score demonstrated 93 % sensitivity and 71.43 % specificity and 86.36% accuracy in comparison to the histopathology which is the gold standard investigation.

Conclusion

Kaiser score is a simple classification model which follows an intuitive tree structure reflecting structured step by step diagnostic process for lesion differentiation, includes five major diagnostic criteria (root sign, dynamic enhancement curve type, margins, internal enhancement pattern, and oedema) and it can be reliable in predicting malignant breast lesions due to its high accuracy, which can decrease the percentage of unnecessary breast biopsies. This has a positive potential to impact healthcare costs, as well as patient concern.
Role of Magnetic Resonance Imaging in Evaluation of Trigeminal Nerve Anatomical Variations That Participate in Trigeminal Neuralgia
Authors: Shakr Dina Mohamed Ahmed , Taha AbdelAziz Tougan , Ashour Manar Maamoun
Published: November 2024

Background

Trigeminal neuralgia (TN) is characterized by recurrent attacks of pain that cause patients distress and even can lead to psychiatric disorders. The International Classification of Headache Disorders-3 (2018) has broadly divided TN into three categories: (1) classical TN, (2) Idiopathic TN, and (3) Secondary TN. The cause of classical TN is neurovascular conflict (NVC). Because idiopathic TN patients don't have an evident cause, it's necessary to search for other factors that can cause TN. These factors include variable abnormal morphological changes of the trigeminal nerve and CPA structures. Neuroimaging plays a crucial role in the diagnosis of patients with trigeminal neuralgia.

Objective

To validate the diagnostic value of the associated anatomical variants (e.g., trigeminal nerve length) between the symptomatic trigeminal neuralgia and asymptomatic trigeminal nerve with no prior history of hemifacial pain or neuralgia.

Patients and Methods

This study was a retrospective case-control study, and the study was conducted at Ain Shams University Hospitals, Radiodiagnosis department. The study period 7 months. Included Patients with clinically diagnosed trigeminal neuralgia.

Results

There was a significant difference between the sides with and without TN in the measurement of the cerebellopontine angle (CPA) surface area. The CPA surface area was smaller on the symptomatic side. On the other hand, there was no significant difference in the trigeminal nerve's cisternal segment length between the symptomatic and the asymptomatic side.

Conclusion

In our study, by using 3D-DRIVE imaging, we demonstrate the validity of smaller CPA surface area on the symptomatic side, as a potential factor for TN diagnosis.
The Role of BT-RADS Scoring System in Post Treatment Assessment of Brain Gliomas
Authors: Mohammed Eman Mohammed Kamal , Meguid El-Shinnawy Maha Abdel , Ashour Manar Maamoun
Published: November 2024

Background

Brain tumors are a diverse group of neoplasms that are a source of substantial morbidity and mortality worldwide. Gliomas constitute most of the primary malignant brain tumors, with the most aggressive as well as most common form in adults, grade IV glioma or glioblastoma multiforme, carrying an especially poor prognosis. Neuroimaging plays a crucial role in the diagnosis and management of patients with gliomas that requires complex multi-specialty treatment.

Objective

To evaluate the added value of applying BT-RADS scoring system on post- treatment imaging follow up in patients with gliomas.

Patients and Methods

this study is a retrospective study and the study was conducted at Ain Shams University Hospitals, Radiodiagnosis department. The study period 9-12 months. Included Patients with histopathologically proven brain glioma.

Results

Implementation of the BT-RADS scoring system in post-treatment assessment of brain gliomas and studying its diagnostic performance showed that the 6 months post treatment BT-RADS score had the highest diagnostic performance with higher AUC, sensitivity, specificity, PPV, NPV and Accuracy of 0.861 (0.740 to 0.940), 77.8%, 94.4%, 87.5%, 89.5% respectively followed by the BT-RADS at 3 months with AUC=0.806 (0.675 to 0.901), sensitivity of 72.2%, specificity of 88.9%, PPV of 78.5%, NPV of 88.5% and Accuracy of 83.3%. The Diagnostic performance of the individual criteria of the BT-RADS scoring system, including (Enhancement, FLAIR and Mass effect) showed that the enhancement criteria had a higher diagnostic performance than the FLAIR, and the mass effect criteria with a higher AUC of 0.819 (0.691 to 0.911), and a higher sensitivity, specificity, PPV, NPV and accuracy of 72.2%, 91.7%, 81.3%, 94.3%, and 85.2% respectively. While both FLAIR and mass effect showed the same diagnostic performance with AUC=0.806 (0.675 to 0.901), and sensitivity of 72.2%, specificity of 88.9%, PPV of 76.5%, NPV of 86.5%, and accuracy of 83.3%

Conclusion

In our study we implemented the BT-RADS scoring system on 54 patients of brain gliomas and studied the diagnostic performance of BT-RADS scoring system in the early and accurate detection of tumor progression and showed high sensitivity and specificity in prediction of tumor progression in relation to patients’ outcome at 12 months (Gold standard).