bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation between Epicardial Adipose Tissue and the Occurrence of Acute Coronary Syndrome Using 2D Transthoracic Echocardiography
Authors: Leon Ramez Khaled , Baraka Mahmoud Mohamed , Esmail Yasmin Abdel Razek , Guindy Ramez Raouf
Published: November 2024

Aims and Objective

The aim of this thesis is to study the correlation between epicardial adipose tissue, as it’s measured by 2D echocardiography and the occurrence of acute coronary syndrome in the Egyptian population.

Patients and Methods

The study included 100 patients, all of which were presenting with chest pain and underwent coronary angiography followed by 2D echocardiography. The population was then subdivided according to angiographic findings; 50 Patients who had an angiographically significant stenosis over 50% and consequently underwent PCI, and 50 age-matched patients with their coronary angiography showing normal coronaries, as the control group.

Results

Our study has shown that epicardial adipose tissue was thicker in individuals presenting with acute coronary syndrome in comparison to the controls group. We also found that EAT showed a statistically significant and directly proportional relationship with HbA1C, RBS, weight, BMI (in the form of increasing weight and/or decreasing height) and TG.

Conclusion

Our study has revealed that measuring the thickness of EAT using 2D echocardiography showed that EAT was thicker in the patients group presenting with ACS than in the control group, with a cut- off value of 6.6mm. This non-invasive method could have the potential for predicting the occurrence of acute coronary syndrome.
Type 2 Myocardial Infarction; Patients Characteristics & Clinical Outcomes
Authors: Sharaf Sherif , Tamara Ahmed , Elbarbary Ahmed , Hasanein Adel , Ibrahim Mostafa
Published: November 2024

Background

Type 2 myocardial infarction are emerging concepts suspected of being common in emergency departments (ED). However, their respective frequencies, risk profiles, and short-term prognoses remain to be investigated

Objective

To assess prevalence and differences in clinical features, current treatment strategies. and outcome in patients with type 2 versus type 1 acute myocardial infarction

Methods

This Cross sectional prospective study was conducted on 350 Egyptian patients presented in a setting of myocardial infarction allocated to two groups; type I MI and type II MI based on their diagnostic criteria. All patients were recruited from Ain Shams University hospital, Misr University for science and technology hospital during a period of one year [from February 2022 to February 2023 then patients were followed regarding prevalence, patient characteristics, in hospital management and clinical outcomes especially mortality (in-hospital, 30 days and 6. months), MACE and heart failure hospitalization]

Results

The mean age of the studied cases was 56.35 ± 9.52 years, males represented 56.3% of cases, there were 54.9% of the studied cases smokers, 23.1% had a history of IHD, 20% with history of CHF, and 38.3% had a positive family history of heart disease. DM was present in 45.4% of cases while HTN was present in 75.1% of cases. Regarding the type of MI, most of the studied patients had type I (74.9%) and 25.1% had type II MI. There was a significant higher length of stay in type II (median 12 days compared to 5 days) in type I and occurrence of death (13.6% Vs 5.7%) in type I and stroke at 6 months also was significantly higher in type II (3.4% Vs 0.4%) in type I but at 1 month MACE didn’t differ significantly

Conclusions: Type I myocardial infarction is more prevalent than type II, however type II MI is associated with higher mortality rates and longer duration of hospital admissions. The clinical presentation differs between both types where type I MI patients present with chest pain, type II patients present mainly with dyspnea, syncope and dynamic instability. Also, the management plan. differs significantly showing that cardiac intervention is mainly directed for type I MI patients
A Comparative Study between Surgical Cut Down and Percutaneous Closure Devices in Management of Large Bore Arterial Access Used in Structural Heart and Endovascular Interventional Procedures
Authors: Samir Wafed , Tantawy Mahmoud Ahmed , Tamara Ahmed Fathy , El Zahwy Sherif Samir , Mousa Mohamed Ali
Published: November 2024

Background

Compared to conventional open surgery, minimally invasive catheter-based procedures including transcatheter aortic valve implantation (TAVI) and endovascular aneurysm repair (EVAR) have less post procedural complications. TAVI and EVAR require large bore arterial access. Optimal site management of large bore arterial access is pivotal to reduce the hospital- acquired complications associated with large bore arterial access. We wanted to compare surgical cutdown versus percutaneous closure devices in site management of large bore arterial access.

Methods

Participants planned for TAVI or EVAR with large bore arterial access more than 10 French were included, while participants with history of bypass surgery, malignancies, thrombophilia, or sepsis were excluded. A consecutive sample of 100 participants (mean age 74.66 ± 2.65 years, 61% males) was selected, underwent TAVI or EVAR with surgical cutdown (group 1) versus TAVI or EVAR with ProglideTM percutaneous closure device (group 2).

Results

The incidence rate of hematoma was significantly lower in group 2 versus group 1 (p = 0.014), the mean procedure time (minutes) and the median hospital stay (days) were significantly higher in group 1 versus group 2 (t(98) = − 2.631, p = 0.01, and U = 2.403, p = 0.018, respectively), the hemoglobin drop and number of packed red blood cells required for transfusion were significantly higher in group 1 vs group 2 (1.35 ± 0.53 gm/dl vs 1.15 ± 0.29 gm/dl, t(98) = 2.403, P = 0.018 and 0.12 ± 0.33 vs 0.06 ± 0.99, t(98) = 2.975, P = 0.004, respectively), and the c-reactive protein pre- procedure and the c-reactive protein post-procedure were significantly lower in group 2 versus group 1 (U = -2.969, p = 0.003, and U=-2.674, p = 0.007, respectively).

Conclusions

Our study showed a lower incidence rate of large bore arterial access complications as hematoma, a shorter procedure time, a shorter hospital stay, lower hemoglobin drop, and fewer packed RBCs required for transfusion with percutaneous closure devices compared to surgical cutdown.
Changes of Left Ventricular Global Longitudinal Strain and Diastolic Function Parameters in Patients Undergoing Primary Percutaneous Coronary Intervention with TIMI Flow Grade III after Anterior ST Segment Elevation Myocardial Infarction
Authors: Mady Youssef , Mansour Amr , William Viola , Samir Sherif
Published: November 2024

Background

STEMI is the most serious presentation of atherosclerotic CAD carrying the most hazardous consequences. STEMI is caused by occlusion of a major coronary artery and primary PCI is the recommended reperfusion therapy over fibrinolysis if performed by an experienced team as soon as possible. Myocardial infarction makes significant changes in composition, shape, and contractile function of myocardium. Especially left ventricle which is the major contributor to the contractile function of the heart, so it affects the systolic and diastolic functions of the heart.

Objective

To study the dynamic changes of left ventricular global longitudinal strain and diastolic function parameters in patients undergoing primary percutaneous coronary intervention with TIMI flow grade III after anterior STEMI

Methods

This study is a prospective observational study that was conducted at Ain Shams university hospitals, in the time interval from October 2022 till June 2023. A total of 100 Patients with anterior STEMI

Results

Our study showed significant improvement in LV systolic function, GLS and diastolic function parameters after PCI during the follow-up. Age > 53, DM, Chest pain to door > 7 hours and CK-total > 4356 were associated with no GLS recovery in Univariate analysis. In multivariate analysis, Chest pain to door > 7 hours was independently associated with no GLS recovery at follow-up with a sensitivity 90 % and specificity 95%.

Conclusion

In the present study we found Our study showed significant improvement in LV systolic function, GLS and diastolic function parameters after PCI during the follow-up. Age > 53, DM, Chest pain to door > 7 hours and CK-total > 4356 were associated with no GLS recovery in Univariate analysis. In multivariate analysis, Chest pain to door > 7 hours was independently associated with no GLS recovery at follow-up with a sensitivity 90 % and specificity 95%.
Surgical Closure of Ventricular Septal Defect: Contemporary Results and Risk Factors for Electrophysiological Changes
Authors: Soliman Azab Sherif Elasyed , El-Hamid El Midany Ashraf Abd , Ibrahim Mohammed Abdelgayed , Mohamed Ahmed Hassan
Published: November 2024

Background

The surgical closure of a ventricular septal defect is a commonly performed procedure. Postoperative ECG changes are common findings that needs a proper assessment to provide valuable insights into the outcomes of the patients. In this study, we investigate the potential risk factors associated with electrophysiological changes following surgical closure of ventricular septal defects.

Methodology

A Prospective, non-randomized study was conducted from October 2020 to December 2022 on patients scheduled for VSD closure. Patients with prior abnormal Congenital electrophysiological disturbances, Internal pacemaker, Ebstein's anomaly, associated sub-aortic membrane or Hypertrophic obstructive cardiomyopathy, Iatrogenic VSD, need Aortic root dilatation with VSD closure were excluded. 12-lead ECG was reported on ICU admission and daily thereafter till discharge. Various demographic and peri-operative data were recorded and its correlation to the presence of electrophysiological changes and final outcomes were analyzed.

Results

200 patients who underwent surgical VSD closure were included. Arrhythmias occurred in 41 patients (20,5%). The encountered arrhythmias were sinus bradycardia with junctional escape in 24 patients, junctional ectopic tachycardia in 10 patients, supraventricular tachycardia in 2 patients, premature complex in 2 patients, 2nd degree heart block in 4 patients and 3rd degree block in 2 patients. Mother's hypertension, preoperative mechanical ventilation, Associated cardiac anomalies, Down syndrome, size of VSD, type of VSD, Total bypass time, Aortic cross clamp time, Concomitant procedures, Intra operative pacing, and residual VSD, were identified in a univariate analysis as Risk factors for occurrence of arrhythmias. The multivariate logistic regression analysis shows that the most significant risk factors for the occurrence of ECG changes were outlet VSD type, mitral valve repair as a concomitant procedure and aortic cross clamp time >45 minutes.

Conclusion

Surgical VSD closure is a safe procedure with low mortality and morbidity rates. Younger age and lower body weight are risk factors for prolonged hospitalization, intensive care unit stay and mechanical ventilation. Longer crossclamp and CPB times were significant predictors of post Op ECG changes and associated complications with prolonged ICU and hospital stay.
Prevalence of COVID 19 Respiratory Failure among Egyptians in Abbasia Chest Hospital
Authors: Assal Gehan El , Ezzelregal Heiba Gamal , Talaat Mohamed Nbil
Published: November 2024

Background

COVID-19 is a serious respiratory infection marked by fever, dry cough, and dyspnea (Huang et al., 2020). While mild symptoms are encountered by most infected people, who do not need hospitalization, a considerable percent of admitted patients were complicated with acute hypoxemia and needed assisted ventilation in ICU.

Objectives

Measure the prevalence of respiratory failure in COVID 19 patients among Egyptians in Abbasyea chest hospital.

Subjects and Methods

COVID 19 patients admitted or coming to Abbaseya Chest Hospital were included in the study during the period between June 2020 to January 2021 All patients subjected to detailed medical history, laboratory investigations and radiological assessment with chest X-ray and computed tomography.

Results

This current study included 130 patients with COVID-19 infection. the prevalence of respiratory failure (defined as PO2 < 60) was 36.2%. The majority of the cases had type I respiratory failure (85.1%). The mean age of the included cases was 51.40 ± 16.79 years with range between 13 and 87 years. There was equal sex distribution as males and females both represented 50% of the included cases. It was found that age more than 46 years old, comorbidities, DM, COVID severity, NLR and TLC more than 8 mm3 were considered highly significant predictors for presence of respiratory failure in COVID 19 patients. Cough, fever, bone ache and lymphocytes more than 0.98mm3 were considered significant predictors for presence of respiratory failure in COVID 19 patients.

Conclusion

COVID 19 patients with respiratory failure showed highly significant increase in disease progression, discharge on oxygen therapy and mortality. it was found that age more than 46 years old, comorbidities, DM, COVID severity, NLR and TLC more than 8 mm3 were considered highly significant predictors.
Serum Complement C1q in Egyptian Patients with Incidental Cerebral Small Vessel Disease
Authors: Derbalah Haitham El-Sayed , Amin Aref Hany Mohammed , El-Nahas Nevine Medhat , El-Bassiouny Ahmed Ali , Mohamed Nesrine Aly
Published: November 2024

Background

Cerebral small vessel disease (CSVD) is associated with increased risk of death and ischemic stroke in patients with atherosclerotic disease. Identifying new biomarkers is mandatory for early diagnosis and proper management.

Aim of the Study

The aim of this study is to investigate the role of serum complement C1q as a potential biomarker for early diagnosis of CSVD in a sample of Egyptian patients.

Patients and Methods

30 patients with CVSD and 20 healthy volunteers who were matched for age and sex were recruited. Serum complement C1q was determined by ELISA according to manufacturer instructions.

Results

Serum C1q levels were significantly higher in CVSD patients compared to healthy controls. On the other hand, serum C1q levels were not significantly correlated with clinical symptoms or radiological findings in this population.

Conclusion

Complement C1q may play a role in pathogenesis of incidental cerebral small vessel disease and warrants further studies.
Study of the Association between MTHFR Polymorphism (rs1801133) and the Outcome of Methotrexate Treatment in Rheumatoid Arthritis Patient
Authors: Rafat Mohamed Marwa Mohamed , Shaheen Karim Yehia , Mohamed Noha Refaat , Abdel-Ghani Amani Mohamed , Ahmed Fathi Marium El-Sayed , Badr Mohammed Fatma Mohammed
Published: November 2024

Background

Rheumatoid arthritis is a chronic systemic autoimmune disease that causes loss of joint function and significantly reduces the quality of life. Methotrexate is one of the disease- modifying anti-rheumatic drugs that can influence treatment efficacy and toxicity. Methotrexate is used as an anchor drug for the treatment of rheumatoid arthritis and there may be differences in drug action between genotypes.

Aim of the Work

The present study was aimed to evaluate the impact of methylenetetrahydrofolate reductase (MTHFR) gene C677T (rs1801133) polymorphism on the clinical outcome of methotrexate treatment as regards treatment efficacy or toxicity in Egyptian rheumatoid arthritis patients.

Subjects and Methods

This study conducted on 45 patients diagnosed with rheumatoid arthritis receiving methotrexate as a first line of treatment. Subjects were classified into two groups; group I (responders, n = 25) and group II (non-Responders, n = 20) according to clinical response to methotrexate by using disease activity score (DAS28). Complete blood count, erythrocyte sedimentation rate, liver function, renal function, C- reactive protein, cyclic citrullinated peptide antibody and rheumatoid factor were done for all patients. Determination of methylenetetrahydrofolate reductase gene C677T (rs1801133) polymorphism was carried out using Real-time polymerase chain reaction.

Results

The present study did not confirm the presence of a significant association between the genotypic frequencies of the methylenetetrahydrofolate reductase gene C677T (rs1801133) polymorphism among the responders and the non-responders group in patients with rheumatoid arthritis. In addition, the methylenetetrahydrofolate reductase gene C677T (rs1801133) polymorphism did not show significant difference between disease complications among the responders and the non-responders groups. On the other hand, our findings suggested that a statistically significant difference was found between two groups of patients regarding disease activity score (DAS 28).

Conclusion

The current study revealed that there is no significant association between the genotypic frequencies of the methylenetetrahydrofolate reductase gene C677T (rs1801133) polymorphism among the responders and the non-responders groups of patients with rheumatoid arthritis. Moreover, the methylenetetrahydrofolate reductase gene C677T (rs1801133) polymorphism did not show significant difference between disease complications among the responders and the non-responders groups in patients with rheumatoid arthritis.
Association between SMAD7 Gene Polymorphism rs4939827 (T>C) and Colorectal Cancer
Authors: Elsaid Shimaa Elmorsi , Elgohary Eman Abdelmoniem , Ahmed Youssri Walaa , Abd-Wahed Marwa Ali , Mahmoud Bahig Nouran , Ahmed Saad Kareem
Published: November 2024

Background

Colorectal cancer (CRC) is a global disease with a high incidence and mortality rates. In Egypt, more than one third of CRC cases occur in individuals aged 40 years or younger and they are diagnosed at advanced stages. Modifiable risk factors include obesity, physical inactivity, diet, and smoking and non-modifiable risk factors such as age, sex play an influential role in CRC etiology. Single nucleotide polymorphisms (SNPs) have been shown as appropriate markers that can predict the susceptibility to various diseases such as CRC.

Objective

This study aimed to investigate the association of SMAD7 gene polymorphism (T > C) with CRC.

Materials and Methods

This study was designed as a case–control association study. After obtaining ethical approval and informed consent, blood samples from 30 CRC patients with colorectal cancer were collected and DNA was extracted. The rs4939827 of SMAD7 was genotyped using TaqMan assay Real-Time PCR.

Results

The C allele of SMAD7 rs4939827 could be protective against colorectal cancer risk. Allele frequency in CRC patients compared to controls (50% vs 55%): OR = 1.58, 95%CI (0.72–3.47), p > 0.05.

Conclusion

The study demonstrated the presence of a non statistically significant relation between T>C polymorphism and CRC However, the (C) allele could be protective for CRC and (T) allele could be associated with a higher stage of CRC.
Evaluation of Intralesional Methylene Blue Medicated Photodynamic Therapy versus Intralesional Cryotherapy in Treatment of Anogenital Warts: Comparative Study
Authors: Mohammed Ghada Fathy , El Nahas Khaled Ahmed , Anis Basma Mohamed
Published: November 2024

Background

Genital warts caused by human papillomavirus (HPV) are one of the most common sexually transmitted infections with no definitive ideal curative treatment. Photodynamic therapy (PDT) destroys. Both topical crytherapy and MB/PPT were effective treatment modalities of common warts.

Aim of the Work

is to evaluate the safety and efficacy of intralesional cryotherapy in comparison with intralesional methylene blue medicated photodynamic therapy in the treatment of genital warts.

Patients and Methods

Our study included 30 patients with multiple genital warts divided into two equal matched groups. One group was subjected to intralesional cryotherapy and the other was subjected to intralesional methylene blue medicated photodynamic therapy every week for maximum five sessions. Follow-up was done for 8 weeks after last session.

Results

This study reports that both treatment options showed statistically significant value in treatment of genital warts, and here was a statistically significant difference between both study groups as regard response to treatment that was higher in the intralesional cryotherapy group.

Conclusion

Both intralesional cryotherapy and intralesional methylene blue medicated photodynamic therapy are effective modalities for treatment of multiple genital warts with excellent safety profile. Intralesional cryotherapy; being more safe and inexpensive, may be considered as a competing treatment modality for multiple and recurrent genital warts.
Dermoscopic Features of Cutaneous Hypopigmented Lesions
Authors: Moneib Hoda , Elfattah Afify Ahmed Abdel , Mohamed Lobna Abdelfattah , Nagy Marina Refat
Published: November 2024

Background

Pigmentation disorders are rather common in dark skin. In India, 11% of patients presenting to the dermatology outpatient department in Western India have pigmentary disorders. Recently, dermoscopy has been involved as an important tool in the diagnosis of various dermatological diseases.

Aim of the Work

The aim of this study was to describe the Dermoscopic features of some hypopigmented skin disorders that may be clinically overlapping in order to facilitate differentiation between these skin disorders.

Patients and Methods

This Cross section descriptive study included 104 patients who complained of patchy or macular hypopigmented lesions.

Results

The most common dermoscopic features of progressive vitiligo were; Perifollicular hyperpigmentation, diffuse white glowing areas, white vellus and terminal hairs. The most common dermoscopic features of repigmenting vitiligo were; perifollicular pigmentation, marginal hyperpigmentation and interfollicular pigmentation. The most common dermoscopic features of stable vitiligo were; starburst appearance and altered pigmentation, marginal hyperpigmentation and perifollicular pigmentation. The most common dermoscopic features of idiopathic guttate hypomelanosis were; multiple, shiny and porceilin like macules, most of the lesions were well- defined (amoeboid pattern), few lesions were ill-defined with irregular cloudy whitish pattern (nebuloid pattern) and hyperpigmented networks were seen on the surrounding skin of some lesions giving the appearance of the cloudy-sky pattern. The most common Dermoscopic features of nevus depigmentosus were; hypopigmented patch with irregular and serrated borders, faint reticular network in some patches, borders showed pseudopods pattern protruding into the normal skin, the surrounding skin was scaly on some lesions and hair was pigmented with no peri-follicular hyperpigmentation. The most common dermoscopic features of pityriasis alba were; fairly demarcated hypopigmented macules, fine scales and hair inside patches of normal color.

Conclusion

Dermoscopy can aid in the diagnosis of hypopigmented skin disorders and can help in assessing the activity of vitiligo, however in sometimes the condition may be challenging and difficult to differentiate even by dermoscopy and in such cases histopathological examination may be helpful.
Needling Technique (with or without Cryotherapy) versus Cryotherapy Alone in Treatment of Multiple Plantar Warts
Authors: Khafagy Naziha Hafez , Elhusseiny Rania Mahmoud , Fouad Abdel Rahman Yasmine Ahmed
Published: November 2024

Background

Plantar warts are common benign tumors caused by human papilloma virus (HPV) infection of the epidermal cells with an estimated annual incidence of 14%. Needling, a novel therapeutic approach, stimulates the immune system resulting in clearance of even untreated lesions, in several patients. Introduction of human papilloma virus infected keratinocytes into the subcutaneous layer may facilitate a desired immune response. On the other hand, Cryotherapy, an inexpensive and simple traditional provider administered procedure using liquid nitrogen in a spray or cryoprobe, is frequently used in many countries as a first line of treatment of plantar warts.

Objective

To evaluate the efficacy and safety of immunotherapeutic modality (needling) versus locally destructive modality (cryotherapy), as well as combination of both immunotherapeutic modality and locally destructive modality (cryotherapy) in treatment of multiple plantar warts.

Methods

This is a randomized therapeutical prospective clinical study included 60 patients aged from 19 to 55 years with planter warts (>2) who haven't received treatment for the condition within the previous month, divided into 3 groups, 20 patients per group, one group subjected to needling procedure, another group subjected to cryotherapy and the third group subjected to a combination treatment of both needling and cryotherapy.

Results

Regarding patients' satisfaction, there was a statstical significant difference between the 3 studied groups as regard patients' satisfaction (median/range), being higher in cryotherapy and combined treatment groups than in needling group. This is the rapid effect of cryotherapy in warts treatment which shows higher scores in the 8th week. Also, not all patients are satisfied with needling since it is not commonly used as cryotherapy, which makes patients question its efficacy especially when used alone. As it is a painful procedure that has to be performed with local anesthetic which consumes a lot of time. Regarding reported side effects of our study, patients of needling group experienced pain, mild bleeding and mild infection. While patients of cryotherapy group experienced pain, blistering, infection and high recurrence rates. Patients of the combination treatment group experienced pain, mild bleeding and blistering.

Conclusion

Combining cryotherapy (locally destructive method) and needling (immunotherapeutic method) provides promising results as it combines benefits of cryotherapy, being rapid, safe and shows rapid response together with benefits of needling, being an immuno-stimulant that provides effective, long lasting, minimally invasive, low-cost treatment with excellent safety profile and low recurrence rates for treatment of plantar warts.
Pediatric Septoplasty: Effect on Nasal Breathing and Need for Revision Surgery, Systematic Review and Meta-Analysis
Authors: Attia El Shalma Ahmed Adel , Rabie Amr Nabil , Mohamed El Begermy Marwa , Mounir Michael
Published: November 2024

Background

Some children with a deviated nasal septum show no symptoms, but up to 30% have breathing problems. Septal deviation is usually caused by microtrauma during delivery, but in severe cases, trauma is the main cause. Many people fail to recognize septal damage after trauma, &children with untreated septal abnormalities often have severe problems. Thus, we can see why symptoms increase with age.

Objective

This review seeks to establish, through the available literature, the effect of nasal septoplasty among pediatric patients on nasal breathing and need for revision surgery.

Subjects and Methods

Prospective and retrospective studies published in peer-reviewed journals including clinical trial, cohort study, cases, cross sectional.

Results

Five studies.4,5,6,8,9 151 people assessed NOSE pre- and post- pediatric septoplasty. The pooled mean NOSE score difference between pre- and postoperative evaluations was -50.26 (95% CI, -62.55 to -37.97), showing a substantial decrease. In Saeed et al. [20], mean differences ranged from -71 points (95% CI, -75.41 to -66.59) to -30 points in Lee (2017). Surgical benefits were regularly shown. Each year of follow-up did not substantially lower NOSE score improvement by 0.39 (SE = 0.29; P = 0.17; I² = 89.6%) in a meta-regression analysis In children, NOSE score improvement increased by 6.36 per year (SE = 1.14; P = <0.001; I² = 34.45%). In a meta-regression research on revision rates following pediatric septoplasty, each year of follow-up raised the rate by 0.13 (SE 0.02; P < 0.001; I² = 4.78%). However, revision rates were not significantly associated with each year of pediatric age (coefficient, -0.39; SE 0.22; P = 0.075; I² = 86.25%).

Conclusion

Septoplasty improves nasal airway function and nasal obstruction in children, according to this comprehensive review and meta-analysis. NOSE Scale disease specific QOL improved significantly after pediatric septoplasty. According to the meta-regression analysis (Table 7), each year of follow-up time resulted in a 0.39 drop in NOSE score improvement (SE = 0.29; P = 0.17; I² = 89.6%). Each year of pediatric age increased NOSE score improvement by 6.36.
Vestibular Rehabilitations Therapy (VRT) in Patients with Persistent Postural Perceptual Dizziness (PPPD)
Authors: Kamal Ibrahim Nadia Mohamed , Abdelmonem Hazza Nagwa Mohamed , Galal Eman Mohamed , Yaseen Dhiaa Mohammed
Published: November 2024

Background

Persistent functional dizziness has been known for many years under various names, including phobic postural vertigo (PPV), visual vertigo and chronic subjective dizziness (CSD). In response to an initiative by the Bárány Society 2017, these terms have recently been grouped together under the umbrella term ‘Persistent Postural-Perceptual Dizziness PPPD' and have been given their own diagnostic criteria.

Aim of the Work

To evaluate posture and cognitive functions in patients with PPPD and to study the efficacy of VRT for management of abnormal postural control in patients with PPPD utilizing subjective and objectives outcome measures.

Materials and Methods

Thirty-three PPPD patients participated in this study. Selection of study group was based on the diagnostic criteria for PPPD proposed by Barany society shown in the International Classification of Vestibular Disorders (ICVD) 2017. Every patient was subjected to history taking, cognitive functions assessment (Mini Mental State Examination and Anxiety and Depression Assessment), Arabic Version of Dizziness Handicap Inventory (DHI), vestibular laboratory tests: Videonystagmography VNG, Video Head Impulse vHIT, cervical and ocular Vestibular Evoked Myogenic Potentials, and Computerized Dynamic Posturography CPD). All patients received Vestibular Rehabilitations Therapy (VRT). Assessment of VRT outcome was conducted by DHI and SOT after 6 weeks of VRT.

Results

Unsteadiness (91%), dizziness (85%), and non-spinning vertigo (76%) were the three main symptoms of PPPD patients. Additionally, patients with PPPD demonstrated questionable (39.4%) and mild cognitive impairment (30.3%). According to vestibular laboratory tests, (42.4%) of patients had peripheral vestibular abnormality, (30.3%) showed normal laboratory test. There was statistically significant difference between before and after VRT as regards DHI and all the sensory analysis of posturography conditions of (SOT).

Conclusion

Supervised sessions using smart CDP systems and home- based VRT were effective in improving patients with PPPD evidenced by subjectively improved DHI scores and objectively improved SOT results.
The Effect of Orbital Exenteration on the Management of Rhino-Orbito-Cerebral Mucormycosis
Authors: Abdel Azeem Mansour Ossama Ibrahim , Ali Nasr Askoura Anas Mohamed , Kamel Abdel Aty Ahmed Mohamed , Elsayed Elsayed Mohamed Mohamed
Published: November 2024

Background

Rhino-orbito-cerebral mucormycosis (ROCM) is a life-threatening acute angio- invasive fungal infection caused by Mucoraceae family. in immunocompromised individuals. Fungal inoculation starts in the nose and paranasal sinuses and then infiltration of the surrounding bone and soft tissues when it reaches the orbit or the brain, fatal complications may follow. The management of ROCM needs a multi disciplinary approach containing sino-nasal and orbital endoscopic debridement along with systemic antifungal drugs. when the orbit is severely affected, immediate orbital exenteration is a must to enhance the patient’s survival and limit the spread of the disease.

Aim of the Study

The aim of this systematic review is to identify the effect of orbital exenteration in the management of orbital invasion in ROCM patients on the improvement of patient survival and prognosis.

Patients and Methods

Studies included are Retrospective observational and prospective studies conducted in the last 20 years Participants included: Patients with ROCM fulfilling the clinical, radiological and pathological/microbiological criteria for diagnosis with ROCM

Results

Orbital exentration halts ROCM progression and overall Survival rates of orbital exentration have been improved in last 20 years becoming as high as 82.6 % in our study. Survival rates of orbital exenteration in ROCM patients after Covid 19 were 84.5% compared to 60.6% before covid 19. Also the recovery time reduced to 36.6 days in this metalysis with a promising results in reconstructive surgeries for cosmetic and psychological efforts.

Conclusion

Orbital exentration together with medical treatment and sinus debridement control ROCM progression. Patients’ survival and recovery time have been enhanced using this aggressive procedure. No guidelines is found concerning when the exenteraton should be done
The Effect of Vitamin D Supplementation on Insulin Resistance and Progression from Prediabetes to Diabetes Mellitus: A Systematic Review/Meta-Analysis
Authors: Hassan Anan Ahmed , Eid Yara Mohamed , Abou Shady Manal Mohamed , Abdelsalam Mona Mohamed , Mohammad Salwa Mostafa , Mohamed Sherihan Aboelyazed
Published: November 2024

Background

Emerging evidence suggests that altered vitamin D and calcium homeostasis play a role in type 2 diabetes mellitus development. Binding of vitamin D to its receptors stimulates the expression of insulin receptors and activates glucose transporters. Additionally, vitamin D regulates calcium concentration in β-cells, which enhances insulin secretion.

Objective

To evaluate the effect of vitamin D supplementation on insulin resistance and glycemic control in prediabetes.

Materials and Methods

We searched databases including CENTERAL, Medline (PubMed), Web of Science, EMBASE and Egyptian Knowledge Bank (EKB) for randomized controlled trials (RCTs) comparing vitamin D or it’s analogues with placebo, RCTs published in English language until December 2022 were included, participants were adults (≥18 years old) with laboratory-confirmed diagnosis of prediabetes by fasting blood glucose (FBG) and/or 2-hour plasma glucose after an oral glucose tolerance test (OGTT) and glycosylated hemoglobin (HbA1c). A total of 3616 studies were retrieved, and 3603 were excluded due to different populations, exposures, or languages. Studies with different outcomes, cross-sectional studies, cohort studies, case reports, case series, and commentaries, along with studies conducted on animals, were also excluded. Thirteen randomized controlled trials were included in this systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for reporting.

Results

Included thirteen RCTs showed improvement in FBG (Pooled standardized mean difference (SMD): −1.239, 95% confidence interval (CI): −1.858, −0.621, P value: <0.001), HbA1c (SMD: −0.736, 95% CI: −1.225, −0.246, P value: 0.003) and, OGTT (SMD: −0.665, 95% CI: −1.237, −0.094, P value: 0.023) respectively. Regarding heterogeneity, random effect model was considered as per I2 statistics for each FBG (96.52%, P value: <0.001), HbA1c (94.52%, P value: <0.001) and, OGTT (95.00%, P value:<0.001) respectively.

Conclusion

Vitamin D supplementation reduced the risk of new-onset type 2 diabetes mellitus. Additionally, it might boost the rate at which prediabetes returns to normal.
Application of Digital Vernier Caliper on Adult Egyptians’ Dental Arches for Age and Sex Identification
Authors: Salem Fatma M , Messih Mary S Abdel , Hadhoud Rania M
Published: November 2024

Background

Forensic odontology is the application of the science of dentistry to the field of criminal and civil laws. Dental arch dimensions are used in forensic medicine to aid the identification of living humans and their remains in severe conditions and mass disasters due to the survivability and diversity of dental structures.

Aim

This study aimed to determine and evaluate the usefulness of inter-canine, inter-molar arch widths, and arch depth of the mandible for age and sex identification in adult Egyptian samples.

Methods

This is a prospective study involving 150 Egyptian adult patients (75 male and 75 females) who attended the dental clinic at Ain Shams University Dental Hospital during the period from the beginning of October 2020 to the end of September 2021. Aged from 8 to 50 years and divided into 3 age groups. Both jaw impressions were taken with alginate and study models were prepared, inter canine, intermolar widths, and total arch length were measured in all the cases, and findings were tabulated.

Results

The current study showed a high statistically significant difference between the maxilla and the mandible as regards the ICW, IMW, and TAL dimensions (P value<0.001), all the study measures were higher for males than females in both maxilla and mandible in the three age groups. Maxillary and mandibular inter- canine intermolar widths were statistically significant in sex identification in most age groups, either together or separately, but for total arch length, both jaws are needed to identify sex in all age groups specifically males in the first and third age groups.

Conclusion

Both dental arches’ dimensions (ICW, IMW &TAL) are dependable specific parameters for age and sex identification in adult Egyptians. Recommendation: Further studies are needed to assess different arches forms in the Egyptian population, especially with the presence of other ethnic groups now in Egypt. to identify correlations between the different parameters measured in this study to establish the interactions among them in the human face growth and effect on victim identification.
Assessment of Low Cost Laparascopic Appendectomy A Comperative Study between Intracorporeal Ligation and Clipping to Secure Appendicular Stump
Authors: Nyaz Saad Emad Samuel , Farouk Abadeer Ashraf , Ragheb Ayoub Bishoy Refaat
Published: November 2024

Background

The first laparoscopic appendectomy was done in the 1970s by gynecologists. The standard operation of acute appendicitis is laparoscopic appendectomy where minimal invasive surgery is performed.

Objective

To compare between clipping and intra-corporeal ligation of appendicular stump regarding safety, timing of operation, difficulty, any post operative complication and cost.

Patients and Methods

This was a prospective randomized clinical study will be conducted in Ain Shams University hospitals that was conducted on 100 cases of acute appendicitis that were subjected to laparoscopic appendectomy. They were divided into two groups. Group 1 (50 patients) ligation group. Group 2 (50 patients): clip group.

Results

Our study revealed that, median operative time for intracorporeal ligation group is 55.6 minutes. Median operative time for titanium clips group is 46.44 minutes with highly statistically significant difference. The present study showed that, there was no statistically significant difference between the two group regarding post-operative hospital stay and return to work. In this study, there is no big difference in the total post-operative complications between clipping and intra- corporeal ligation groups.

Conclusion

Both methods of intracorporeal ligation and clip application are cost effective in securing the appendicular stump. metal clip application is more easy to the surgeon, more time saving during the operation and less post-operative stay in the hospital. The only limitation of the clip application is the wider diameter of the base of the appendix beyond the large titanium clip in these cases intra-corporeal ligation is a safe and cheap alternative.
Short Term Detection of Gastroesophageal Reflux Disease after Laparoscopic Sleeve Gastrectomy
Authors: Mohamed Abdel-Salam Mostafa Mamdouh , Moustafa Alaa Abbas Sabry , Youssef Ahmed Helmy , Eskandaros Moheb Shoraby
Published: November 2024

Background

Obesity has become one of the most important public health problems in the United States and many other resource-rich countries and transitional economies. As the prevalence of obesity increased, so did the prevalence of the comorbidities associated with obesity. For this reason, it is imperative that health care providers identify overweight and obese patients so that counseling and treatment can be provided.

Objective

Short term detection of gastroesophageal reflux disease (GERD) in morbidly obese patients after being subjected to laparoscopic sleeve gastrectomy (LSG).

Methods

This prospective case series study was carried out on 60 patients was conducted in Surgery Department, Ain Shams University Hospitals Bariatric Surgery unit in the period from June 2018 till June 2021.

Results

Our finding of GERD occurrence was 26.67% (16/60) of patients. So, if GERD with erosive esophagitis or Barrett esophagus or incompetent LES is diagnosed, SG shouldn’t be done. In these clinical situations that are independent of the BMI, Roux en-Y gastric bypass is indicated. Only in a very special group of patients with BMI between 30 and 35 and comorbidities, SG plus other antireflux procedure or hiatal hernia repair is accepted.

Conclusion

There is an agreement with other reports about importance of exclusion of GERD or hiatal hernia preoperatively. We recommend endoscopy before any operation for obesity to exclude hiatal hernia, esophagitis or Barrett esophagus.
Evaluation of Efficacy and Versatility of Wise Pattern Mammoplasty Technique versus Wide Local Excision in Treatment of Upper and Lower Pole Breast Cancer, A Prospective Comperative Study
Authors: Hussein Mostafa Said , Amer Hazem Abdelsalam , Fahmy Karim , Hanafy Dina Mohamed
Published: November 2024

Background

Breast cancer is the most prevalent malignancy in women. Annually, an estimated 2.3 million new cases of breast cancer are identified worldwide. The objective of this research was to compare between the Wise pattern therapeutic mammoplasty and wide local excision in treatment of upper and lower poles breast tumors regarding cosmetic results, oncological outcomes, complications, recurrence and degree of satisfaction of the patients.

Methods

This prospective comparative study was conducted on 40 cases who had upper pole breast cancer (T1-2N0-1M0), lower-quadrant breast cancer, (T1-2N0-1M0]. They were divided into two equal groups: Wise pattern therapeutic mammoplasty group: patients underwent Wise pattern therapeutic mammoplasty (including superior and inferior pedicles). Wide local excision group: patients underwent direct wide local excision.

Results

Recurrence was insignificantly different between Wise patten therapeutic mammoplasty technique and wide local excision technique (P value = 0.5533). Satisfaction was significantly better in Wise patten therapeutic mammoplasty technique than wide local excision technique (P value = 0.024).

Conclusions

despite a longer duration of surgery, the Wise pattern therapeutic mammoplasty technique did not result in increased complications such as non-viable nipple- areolar complex, wound infection or seroma, compared to wide local excision. Therefore, the Wise pattern therapeutic mammoplasty technique appears to be a favorable surgical option for the management of upper and lower pole breast tumors, offering better oncological outcomes and improved cosmetic results with high patient satisfaction, without compromising safety or increasing morbidity.
Evaluation of Laparoscopic Banded One-Anastomosis Gastric Bypass (LB-OAGB); A Retrospective Study
Authors: Zakaria Mahmoud , Matar Mohamed Mohamed , Abou El-Wafa Yahya Zakaria MohamedAli , Morsy Omar Mahmoud Ahmed
Published: November 2024

Background

Laparoscopic one anastomosis gastric bypass (L-OAGB) is a relatively new procedure for the treatment of morbid obesity and related comorbidities. On average, this procedure results in good postoperative weight loss with a low complication rate. Recent publications suggest that dumping syndrome and weight regain might be reduced by placing a silicone ring over the gastric pouch during the procedure, so called laparoscopic banded one anastomosis gastric bypass (LB- OAGB).

Objective

To evaluate the outcomes of the LB-OAGB as regards efficacy and safety in a 12-month postoperative follow up period.

Patients and Methods

This is a descriptive retrospective study conducted in Ain Shams University Hospitals, including 20 patients. They were examined and investigated for weight loss after 1, 6 and 12 months, postoperative complications, comorbidities resolution and malnutrition after 6 months.

Results

14 Female and 6 male patients were included with a mean age of 38.7 years (24–58), mean preoperative body mass index of 46.221 kg/m2 (39.2–56), and mean preoperative weight of 132.5 kg (112–160). 7 patients presented with type 2 diabetes (35%), 5 patients (25%) diagnosed with hypertension and 1 (5%) patient with hyperlipidemia were included. No patienst required reoperation. The hospital stay was one day for 19 patients (95%), while there was 1 patient (5%) who was discharged from hospital after three days due to abdominal colics of irritable bowel syndrome (IBS). In that period, no patient required ring removal or conversion to Roux-en-Y gastric bypass surgery. Food intolerance/ vomiting wasn’t present in any patient (0%), bile reflux was present in 2 patients (10%), 1 patient (5%) presented with alkaline reflux that was readmitted and underwent conservative treatment, and no stomal ulcers were observed. Mean % excess weight loss at 6 and 12 months was 55.72% and 77.36%, respectively. All patients with the reported preoperative comorbidities had a complete resolution of comorbidities. As regards postoperative nutritional deficiencies, we had no cases (0%) diagnosed with anemia, hypoalbuminemia, or iron deficiency. We had one patient (5%) with vitamin D deficiency, and another patient (5%) with hypocalcemia. Both of those patients were not completely compliant on the regular postoperative multivitamin supplements.

Conclusion

Laparoscopic banded One Anastomosis Gastric Bypass is a safe and efficacious procedure with excellent preliminary short-term results. Weight loss in the first year is durable, and dumping syndrome and bile reflux are limited. It also proved effective as regards comorbidities resolution such as DM, HTN and hyperlipidemia, and in case of complications, the ring can be easily removed laparoscopically.