bluuebunny/crossref_metadata_2025 huggingface dataset:
Renoprotective Effect of Febuxostat on Contrast Induced Acute Kidney Injury in Chronic Kidney Disease Patients Stage 3. Randomized Controlled Trial
Authors: Sarhan Iman Ibrahim , Abdellatif Yasser A , Saad Rania Elsayed , Teama Nahla Mohamed
Published: July 2024

Introduction

Contrast induced acute kidney injury (CI-AKI) is known to be a complication of using intravascular contrast injection. Unfortunately, It is associated with adverse outcomes as prolonged length of hospitalization and increased burden of health care costs. So, we aimed to determine the efficacy of febuxostat in prevention of contrast induced acute kidney injury among patients with chronic kidney disease Stage 3 performing percutaneous coronary intervention (PCI).

Methods

In a randomized controlled trial we enrolled 120 CKD stage 3 Patients with acute coronary syndrome referred to the cardiology department Ain-Shams University hospital for performing PCI and stenting. Patients were randomly assigned to two arms: Group I (study group): Included 60 patients who received Febuxostat added to the traditional treatment (IV hydration and N-acetylcysteine). The patients received Feburic 80 mg within 6- 18 hours before and within 6-18 hours after the coronary intervention (a time gap of 24 hours between two doses).Group II (control group): included 60 patients who received only traditional treatment.

Results

The incidence of AKI was higher in the control group with a statistically significant difference. We found that Independent Significant risk factors that led to AKI were febuxostate avoidance, DM, high urea level, high creatinine level, CKD stage 3B, high Mehran score and high AKI risk.

Conclusion

We demonstrated that febuxostat has a renoprotective effect and it can help to reduce the incidence CI-AKI in CKD patients stage 3 performing PCI.
Serum Stabilin1 as a Prognostic Marker in Adults Acute Leukemia Patients
Authors: Mousa Mohamed Mahmoud , Abd-elsamee Hanaa Fathy , Radwan Rania Abd-elmoniem , Sheeba Mahmoud Soliman , Ibrahim Ali Mariam
Published: July 2024

Background

STAB-1 (common lymphatic endothelial and vascular endothelial receptor) was found to be expressed on tumor lymphatic vessels in different malignancies and it is a bad prognostic marker. This study will assess the role of serum stabilin1 (STAB1) as a prognostic marker in adult patients with newly diagnosed acute leukemia and correlate it with the other well established prognostic markers. Acute lymphoblastic leukemia (ALL) is a hematologic malignancy arising from precursors of the lymphoid lineage. Conventional cytotoxic chemotherapies have resulted in high cure rates of up to 90% in pediatric ALL, but the outcomes for adult patients remain suboptimal with 5-year survival rates of only 30%-40%.

Aim of the Work

To measure STAB1 expression in patients with AML and patients with ALL and assess its role as a prognostic factor with correlating it with other prognostic factors.

Patients and Methods

A case control study in Ain Shams University Hospitals, Clinical Haematology and Oncolgy division of Internal Medicine Department for one year on total 75 subjects divided into: 25 patients with newly diagnosed acute myeloid leukemia (AML), 25 patients with newly diagnosed acute lymphoblastic leukemia (ALL) and 25 age and sex matched healthy control subjects. The study population was recruited from Ain Shams University Hospitals, Clinical Haematology and Oncolgy division of Internal Medicine Department.

Results

There was no significant difference between cases of acute leukemia pts and control group as there was no statistically significant difference between control and patients group regarding sex, age, spleen size, liver size, LDH, CRP, uric acid and ESR of the studied subjects. Our study shows that as regard CBC; there was significant difference between the studied groups as regard leucocytic count, BUT Platelets, and hemoglobin was insignificant, which was also described in the study. Our study showed that there was high statistically significant difference between the acute leukemia patients and the healthy control group as regard sabilin1. Our study shows that the mean serum level of stabilin1 in the patients who didn’t respond to chemotherapy was higher than that of the patients that responded to chemotherapy.

Conclusion

There was high statistically significant difference between the studied groups as stabilin1. There was significant correlation between stabilin2 and chemotherapy response. Stabilin1 expression levels also identified a new subgroup at a higher risk for relapse and with a poor prognosis in acute leukemia patients. Stabilin 1 can be used as a prognostic factor in patients with acute leukemia.
Effect of Dialysis Modality and Membrane Permeability on FGF 23 Level and Cardiovascular Calcification in ESRD Patients
Authors: Elsayed Hesham M , Beshary Waleed A , Rezk Khaled M , Mohamed Mostafa A , Ahmed Fatma A
Published: July 2024

Introduction

Cardiovascular disease is the most common cause of death in patients with chronic kidney disease (CKD) and vascular calcification is one of the strongest predictors of cardiovascular risk. The prevalence of vascular calcification increases as glomerular filtration rate (GFR) declines and calcification occurs years earlier in CKD patients than in the general population. (26).

Aim of the Study

To study the effect of hemodialysis modality in controlling FGF-23and to determine the impact of FGF23 on cardiovascular calcification

Patients and Methods

We selected 50 patients ESRD maintained on hemodialysis divided into 2 groups, Group 1: comprised of 25 patients maintained on hemodialysis with high flux dialyzer and Group 2: comprised of 25 maintained on weekly session of hemodiafiltration and comparison between both groups regarding FGF23 serum level in addition to cardiovascular screening for calcifications using ECHO, Carotid intima-media thickness, and carotid duplex.

Results

we found that Post dialysis FGF23 was significantly lower in “hemodiafiltration patients” than ‘hemodialysis patients” and Reduction ratio was significantly higher in “hemodiafiltration patients”(P < 0.001).ECHO score and carotid duplex score were insignificantly different between both groups, but carotid intima-media thickness was significantly higher in haemodialysis patients (P value 0.035). Post HDF FGF 23 had a significant positive correlation with IMT (r = 0.579, P = 0.008). Serum FGF23 post-HD and HDF had significant positive correlation with serum Calcium (r = 0.659, P = 0.002), (r = 0.474, P = 0.035), PTH (r = 0.485, P = 0.03), (r = 547, P = 0.013) and CRP (r = 0.646, P = 0.002), (r = 707, P < 0.001) and serum Phosphorus (r = 0.462, P = 0.04), (r = 478, P = 0.033) respectively. In HD group Carotid Duplex Score had significant positive correlation with serum Ca (r = 0.469, P = 0.037), while in HDF group Carotid Duplex Score had significant positive correlation with PTH (r = 0.59, P = 0.006).

Conclusion

Using online HDF technique showed a significant reduction of FGF23 and improvement of carotid intima-media thickness calcification score.
The Effect of Dialysis Membranes on Coagulation Activation during Haemodialysis of Maintenance Haemodialysis Patients
Authors: Sayed Khalid Samir , El Sayed Hisham , Gharib Mohamed Sary
Published: July 2024

Background

Platelets, leukocytes, and the coagulation cascade are activated during hemodialysis. During hemodialysis, systemic anticoagulation is used to prevent clotting of the extracorporeal circuit which may lead either to complete clotting to the degree that prevent blood return to the patient or to a lesser extent can only affect the dialyzer membrane fibers which will decrease the effective surface area and that will decrease the session efficacy

Aim of the Work

The aim of the current study was to evaluate contact system activation and overall coagulation activation during in vivo hemodialysis in prevalent hemodialysis patients, using current generation dialyzer membranes. A crossover study design allowed assessment of differences among regular dialyzer membranes.

Patients and Methods

We performed a single-center sequential interventional clinical trial study. Twenty patients older than 18 years and treated with maintenance hemodialysis (>3 months) underwent 2 hemodialysis study sessions at Ain Shams University hospitals dialysis unit. Exclusion criteria were clopidogrel or anticoagulant therapy, active infection, presence of central venous catheter or arteriovenous graft and known vascular access dysfunction.

Results

The increase of TAT at 240 minutes after dialysis start in our study, irrespective of the dialyzer membrane used, suggests a late-onset threshold for thrombin generation, which is well before the treatment effect of the UFH is expected to have faded. The changes in TAT dynamics are in line with previously published results. Dialysis treatments were standardized except for dialyzer membrane. Hence, the differences between membranes are most likely due to differences in physicochemical characteristics. Whether these differences are clinically meaningful needs further study. Analysis costs and the exploratory set-up of the trial drove the small sample size and design of the study. A more comprehensive evaluation of the coagulation activation over a longer time period of hemodialysis treatment would be of interest.

Conclusion

Driven by the recent interest in the therapeutic options of specific contact system inhibitors, we aimed to evaluate contact system activation during in vivo he-modialysis. Chronic hemodialysis patients dialyzed through arteriovenous dialysis access show coagulation activation during hemodialysis, marked by increased TAT levels, despite using systemic anticoagulation to prevent macroscopic clotting of the extracorporeal circuit. The increase in thrombin generation markers was not associated with measurable contact system activation. Our results argue against effective contact system activation during hemodialysis and generate the hypothesis that novel specific contact system inhibitors alone might not suffice as anticoagulant treatment during hemodialysis.
Recurrence of Hepatocellular Carcinoma after Living Donor Liver Transplantation Prevalence, Patterns, Perioperative Factors and Outcome
Authors: El Malatawy Mohammed Abd El Fattah , Bahaa El Din Mohamed Mohamed , Mohamed Eslam Safwat , Faheem Heba Ahmed , Shawkey Isac Shadi Emad
Published: July 2024

Background

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third cause of cancer-related mortality world- wide. The incidence of HCC is on the increase, and it is a major threat to our modern life. Epidemiological studies have indicated that HCC are related to chronic hepatitis B virus (HBV) and chronic hepatitis C virus (HCV) infection.

Aim of the Work

To detect prevalence, patterns, perioperative factors and outcome of recurrence of HCC after living donor liver transplantation.

Patients and Methods

This was a cross sectional study based on the review of medical records of all patients undergoing LT at Ain Shams Centre of Transplantation, between January 1, 2010, and December 31, 2018.

Results

we detected prevalence, patterns, perioperative factors and outcome of recurrence of HCC after living donor liver transplantation.

Conclusion

Oral lactoferrin could not be used as a substitute to totally replace IV ferrous sulphate in treating iron deficiency anemia in end stage renal disease (ESRD) on dialysis. Oral lactoferrin could not even control Hb level constant without dropping in patients with end stage renal disease (ESRD). Oral lactoferrin had some gastrointestinal effects on some patients which did not allow compliance on the medication.
The Diagnostic Value of Monocyte Count/HDL Cholesterol Ratio as a New Marker in Diabetic Retinopathy
Authors: Abd El Baky Rania Sayed , Bekhet Meram Mohamed , Aly Salah Hussein , El Gayed Ahmed Amany Talaat Abd
Published: July 2024

Background

Diabetes mellitus is a set of metabolic diseases characterized by chronic hyperglycemia as a consequence of lack in insulin action, secretion, or both. All of which lead to long-term damage and dysfunction of different organs predominantly the eyes, kidneys, nerves, heart, and blood vessels.

Aim of the Work

The aim of the study is to investigate the diagnostic value of MHR in diabetes and whether it can be utilized as an indicator of diabetic retinopathy.

Patients and Methods

This study was a case control study on 100 patients attending diabetes outpatient clinic at Ain shams university hospital 30 male, 70 female. 50 patient with diabetic retinopathy and 50 patient without retinopathy to detect the MHR in each group and to detect whether it can be utilized as an indicator of diabetic retinopathy.

Results

In this study there is a significant correlation between diabetic retinopathy and MHR, MHR being higher in patient with diabetic retinopathy, with a cut-off level of > 0.01 with 74% sensitivity and 64% specificity. Our study showed a significant relation between long standing duration of diabetes mellitus and diabetic retinopathy. Also there was significant relation between diabetic retinopathy with high glycemic profile with fasting blood sugar and 2 hour post prandial blood sugar and Hba1c. The study also show that there is no significant relation between diabetic retinopathy and weight, height, BMI.

Conclusion

Diabetic retinopathy (DR) is a major complication of diabetes mellitus (DM), which remains a leading cause of visual loss in working-age populations. MHR being higher in patient with diabetic retinopathy. And can be it can be utilized as an indicator of diabetic retinopathy.
Serum Selenium Status in Egyptians Patients who had Graves’ Disease with and without Ophthalmopathy
Authors: Hasanin Ghada Atef , Mohamed Magda Shokry , Maher Maram Mohamed , Ali Hanan Mahmoud , Mansour Hany Khairy , Ahmed Said Azza Mohamed
Published: July 2024

Objective

Selenium is effective in improving quality of life and reducing the progression of active Graves’ orbitopathy. The effect of correcting relative selenium deficiency on improving Graves’ orbitopathy is unknown, as baseline selenium levels have not previously been measured. The study aims to determine whether serum selenium levels are reduced in patients with Graves’ disease with orbitopathy (GO) compared with without orbitopathy (GD).

Design

A prospective, case–control study performed between 2019 and 2021 at endocrine and ophthalmology clinics in Ain SHams University, Cairo.

Subjects

A total of 75 subjects, 25 as control and a total of 50 patients with Graves’ disease participated in the study: 25 with Graves’ orbitopathy and 25 without Graves’ orbitopathy. Measurements Serum selenium levels in all groups.

Results

Mean serum selenium levels were significantly lower in GO (16.6 +- 7.5 ng/ml) than in GD (42.9 +- 8.2 ng/ml) with (P < 0.001). Mean selenium levels appeared to decrease in parallel with increasing severity of GO; selenium level was 30-55 ng/ml in GD, 21-28ng/ml in mild GO, 18-22 ng/ml in moderate GO and 5-16 ng/ml in severe GO (P < 0.001).

Conclusion

Serum selenium levels are lower in patients with GO compared with GD in an Egyptian study population with marginal selenium status. selenium deficiency may be an risk factor for orbitopathy in patients with Graves’ disease.
Association of Serum M2BPGi Levels with Nutritional Status (Using CONUT score) in Hepatitis C Virus Related Compensated Liver Cirrhosis Patients
Authors: Keddeas Marcel William , Kaisar Hany Haroun , Elessawy Hagar Ahmed , Abosree Mohamden Nahla Mohsen
Published: July 2024

Background

Protein-energy malnutrition (PEM), which is one of the most common complications seen in LC patients and associated with high morbidity and mortality. So, predicting the presence of PEM and providing appropriate nutritional support help improve the prognosis of those patients. Mac-2-binding protein glycosylation isomer (M2BPGi) was recently identified as a serum glycobiomarker for liver fibrosis. However, the relationship between M2BPGi and malnutrition in patients with chronic liver disease (CLD) is unclear.

Aim of the Work

The aim of this study is to evaluate the role of serum M2BPGi levels as a surrogate marker for malnutrition in HCV related cirrhotic patients, correlated with CONUT score as the nutritional status marker.

Patients and Methods

This is a Cross-sectional - Analytic study that included patients with chronic HCV infection and normal control group selected from patients attending to Hepatology Outpatient Clinics at Ain Shams University Hospital. This study was carried out from 30 patients (child A) attending to Hepatology Outpatient Clinics at Ain Shams University Hospital and 30 healthy individuals as a control.

Results

The M2BPGi levels increased with CONUT score. The correlation coefficient between M2BPGi and CONUT score was r = 0.315 (p = 0.05), indicating a positive weak correlation between M2BPGi and CONUT score. The cut-off for M2BPGi to predict CONUT low vs. moderate was 1.43 with a sensitivity 93.33% and specificity 100% when AUC =0.9 and CONUT moderate vs. severe was 1.7 with a sensitivity 91.67% and specificity 100% when AUC =0.9.

Conclusion

We found that there is correlation between M2BPGi and CONUT score and both can be useful as a marker for malnutrition in HCV related cirrhotic patients cut of point
Impact of Nutrition Education on the Outcome of Bariatric Surgery
Authors: Hamed Elagroudi Reham Mohammed , Ibrahim Wesam Ahmed , Zaky Doaa Zakaria , Anwar Christina Alphonse , Abdelaziz Mohamed Magdy
Published: July 2024

Background

Bariatric Surgery is the most effective way for inducing long term weight loss and decreasing comorbidities and mortality in patients with severe obesity. After the surgery, nutritional counselling is important to facilitate the adaption of eating habit to the new gastric intestinal physiology and to prevent the nutritional deficits arising after the bariatric surgery.

Aim of the Work

Assess impact of nutrition education no outcome of bariatric surgery regarding dietary habits and clinical parameters.

Patients and Methods

This study was carried out on 128 bariatric patients, 64 patients underwent bariatric surgery and took nutritional education session and follow-up for 6months from the first day of performing the operation (Group A), and another 64 bariatric patients performed the surgery six month ago without taking the nutritional education session or any follow-up (Group B).

Results

In Group A (with the nutritional education intervention) there was a statistically significant difference in the eating after bariatric surgery knowledge, taking supplementation, satisfaction level after the surgery, eating habits, anthropometry and weight loss measurements, improving nausea and vomiting symptoms, and better Hb%, albumin level, and improvement in serum TG level, Serum LDL level which decreased and also improvement of HDL level which increased at the six month of performing the operation more than Group B (without the nutritional education intervention).

Conclusion

There is a great importance of nutritional education and compliance to the follow-up after performing the bariatric surgery on the outcome of the bariatric surgery regarding dietary habits and clinical parameters.
Effect of Parathyroid Hormone on Left Ventricular Hypertrophy in Patients on Regular Hemodialysis
Authors: Botros Raef Malak , Bekhet Meram Mohamed , Mohamed Amr Mahmoud , Helmy Marina Nashaat
Published: July 2024

Background

Cardiovascular disease is the most common cause of death in patients with end-stage renal disease (ESRD) and accounts for much of the morbidity in this population.

Aim of the Work

We therefore aimed to consider the evidences regarding the role of excess PTH in the development of left ventricular (LV) hypertrophy as well as LV ejection fraction in patients with end-stage renal disease under regular hemodialysis.

Patients and Methods

This study was cross sectional study and was conducted in hemodialysis unit, Elsahel Hospital. This study was conducted on 70 patients on regular hemodialysis (3 times a week for at least 6 months) for timing of study from January 2022 to June 2022.

Results

In our study, we demonstrated that there was statistically significant relation between P.T.H quartiles and LVMI which found higher in 2nd quartile and lower in 3rd quartile with p-value = 0.036. Our results showed that there was statistically significant positive correlation found between LVMASS and AP, LVEDD, PWT, IVST and LVMI and also negative correlation between LVMASS and weight, BMI and EF% among female patients.

Conclusion

our study suggested the role of hyperparathyroidism in the development of LVH, with a potential impact on cardiovascular outcome for patients on HD. Adverse effects of secondary hyperparathyroidism on LV function and structure showed the role of excess PTH in the development of left ventricular (LV) hypertrophy as well as low LV ejection fraction in patients with end-stage renal disease under hemodialysis which needs more attention to control of secondary hyperparathyroidism to reduce the risk of cardiovascular morbidity and mortality in dialysis patients.
Relationship between Serum Zinc Level and Retinopathy in Type 2 Diabetic Patients
Authors: Eid Yara Mohamed , Ibrahim Wesam Ahmed , Abdelbaky Rania Sayed , Aly Elhalawany Salah Hussein , El Sayed Nouh Mona Ahmed
Published: July 2024

Background

Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycemia caused by insulin resistance (IR) or impaired insulin production. Diabetic retinopathy (DR) is a common microvascular disorder which occurs in type 2 diabetes mellitus (T2DM) patients due to chronic hyperglycemia. Previous studies reported that serum zinc (Zn) was associated with certain diabetic microvascular complications.

Objective

To evaluate relation between serum zinc level and diabetic retinopathy in patients with type 2 diabetes mellitus.

Subjects and Methods

The current study included 60 subjects with their ages ranging from 18- 60, selected from diabetes and ophthalmology outpatient clinics of Ain Shams University Hospitals for 7 months in a period from July 2022 to January 2023 with matched age and sex . fasting and post prandial blood glucose, hemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP),serum creatnine, LDL, HDL, TG,TC and serum zinc levels were measured among groups.

Results

The study shows statistically significant difference between DM type II subgroups regarding duration of disease (yrs) being higher in DM II with retinopathy 12.5 (10.5 – 16.5) than DM II without retinopathy 9 (6 – 12) with p < 0.001. serum Zn levels were significantly lower in the DR group than the controls and diabetic without retinopathy.in whole DM type II group, there was statistically significant negative correlation found between zinc level and duration of diabetes, HbA1c, LDL, TC, FBS, 2PP and serum creatinine level, while in DM II without retinopathy there was statistically significant negative correlation found between zinc level and duration of diabetes, LDL, TC and FBS and also in DM type II retinopathy there was statistically significant negative correlation found between zinc level and duration of diabetes, HbA1c, FBS, 2PP and serum cretainine level .There is no statistically significant difference found between control group and DM type II group regarding weight, height and BMI of the studied patients with p-value = 0.108, 0.198 and 0.343; respectively. There is no statistically significant difference found between control group and DM type II group regarding systolic and diastolic blood pressure of the studied patients with p- value = 0.554 and 0.405; respectively.

Conclusion

Our study suggested that lower serum zinc level in T2D patients was related to higher prevalence of diabetic microvascular complications. Patients with lower serum zinc level were more likely to have a longer duration of diabetes, poorer glucose control, and worse β-cell function. Older age, higher HbA1c level, and the prevalence of DN were risk factors related to the lower serum zinc level.
Selfie Phenomenon among a Sample of Egyptian University Students: Rate and Psychiatric Correlates
Authors: Mohamed Hashem Reem El Sayed , Hassan Ghada A M , EL-sheikh Mona Mahmoud , Hassan Hadeer , Ismail Azzam Lobna Abu-Bakr
Published: July 2024

Background

The SELFIE phenomenon being an emanating one, specifically affecting adolescents and young adults. It emerges as a reflection of a wide spectrum of Neuro- psychiatric disorders. Based on this, the current study aimed to assess the rate of the selfie phenomenon among Egyptian university students, and its sociodemographic and psychiatric correlates. During the study procedure we enrolled 200 undergraduate Egyptian university students from two different faculties and were assessed using the Selfie Behavioral Scale, Structured Clinical Interview for DSM-IV- TR Axis I Disorders, Structured Clinical Interview for DSM-IV- TR Axis II Disorders, and Global assessment of functioning scale.

Results

49.5 % of the students being assessed had borderline selfitis with a higher rate among females, we found a highly significant relationship between the selfie phenomenon and depression, anxiety, obsessive-compulsive disorder, eating disorders, and other psychiatric disorders and personality disorders, we also found that selfie had a significant negative correlation with the level of functioning among students.

Conclusions

results concur with previous existing literature regarding the magnitude of the selfie phenomenon and its relationship with .different psychiatric disorders and personality disorders.
Sleep Disorders Linked to Quality of Life in a Sample of Egyptian Policemen a Comparative Study between Shift Workers and Non-Shift Workers
Authors: Omar Abdelnasser Mahmoud , Elkhayat Naglaa Mohamed , Khalil Sherien Ahmed , Naguib Rehab Mohamed , Mohamed Kotb Mostafa Ahmed
Published: July 2024

Background

Poor sleep is associated with bad health outcomes, worse wellbeing and decreases in performance, productivity and safety at work. Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events and can, as such, develop sleep problems.

Aim and Objectives

To compare quality of life, occupational stress level, between shift &non shift workers policemen working at El-Agouza Police Hospital.

Subjects and Methods

This was a cross-sectional comparative study conducted on 64 policemen working in 6 different Police department recruited from sleep clinic neuropsychiatry department at EL-Agouza Police Hospital serving police officers in El-Nile street, Giza, Egypt.

Result

Occurrence of sleep disorders was significantly higher in the shift workers compared to the non-shift worker group (p < 0.01).

Conclusion

In the current population-based study of police officers, poor sleep quality was more prevalent among officers who were engaged in shift work. The findings are consistent with prior evidence that night shift carried the greatest risk of poor sleep quality because night-shift officers have to make some adaptations that compensate for their natural circadian patterns.
A Systematic Review Comparing Fusion Rates and Cage Subsidence in ACDF by Cage Alone vs Cage and Plate in Multilevel Cervical Disc Prolapse
Authors: Abdel Hamid Ahmed Wael Hamed , Khalil Hamdy Ibrahim , Elsayed Ahmed Mohammed , Elmashad Mohammed Gamal
Published: July 2024

Background

Anterior cervical discectomy and interbody fusion (ACDF) has become the standard procedure for treating degenerative cervical disc disease. Multiple techniques and modalities of fixation are used in ACDF, each with its merits and demerits.

Aim of the Work

The objective of this study is to compare the outcome of anterior cervical discectomy and fusion by cage alone versus surgical fusion by cage and plate in terms of morbidity, mortality, fusion rates, cage subsidence and quality of life estimates in treatment of multilevel cervical disc prolapse.

Patients and Methods

Our search strategy identified a total of 235 citations. Search was done for studies conducted or published within 2010 – 2022. After removal of 58 duplicate studies, eligibility criteria was applied to the titles of 177 articles with the exclusion of non-appropriate study design. This yielded 21 studies that underwent full text analysis of which 13 did not meet the inclusion criteria for having only single level ACDF or short follow up period.

Results

Our study included 8 observational studies (6 retroscpective and 2 prospective) comparing multilevel ACDF with cage alone vs cage and plate regarding fusion rate and cage subsidence, the results showed that while the cage plate group had lower rate of cage subsidence, there was no significant difference in the rate of fusion.

Conclusion

Our study included 8 observational studies (6 retroscpective and 2 prospective) comparing multilevel ACDF with cage alone vs cage and plate regarding fusion rate and cage subsidence, the results showed that while the cage plate group had lower rate of cage subsidence, there was no significant difference in the rate of fusion.
Effect of Primary Arthroplasty on Post Treatment Results among Elderly with Pertrochanteric Femur Fracture
Authors: Awad Mahmoud Mostafa , Basiouny Ayman Abdelaziz , Sayed Kotb Ahmed
Published: July 2024

Background

With an increasing global incidence of hip fractures, designing ppropriate treatment strategies for hip fractures is fundamentally important to healthcare professionals. Evaluation of the role of 1ry arthroplasty in the setting of trauma for the acute treatment of hip fractures will be fulfilled.

Aim of the Work

to review the literature to know the best arthroplastic option for elderly people with pertrochantric fracture and compare between them as regard post-operative complications (infections, bed sores, pneumonia and other chest infections, dislocations), post-operative functional outcome, post-operative dislocation, rate of revision surgrey.

Patients and Methods

The included studies were randomized controlled trials, including cluster RCTs, controlled (non-randomized) clinical trials or cluster trials, prospective and retrospective comparative cohort studies, and case-control or nested case-control studies. The excluded studies were cross-sectional studies, case series, case reports and literature not in English.

Results

after extraction of non-compatible studies as regard our priciples, we setteled on 18 studies that compare different types of primary arthroplasty and their post operative outcome among elderly with pertrochanteric femur fracture. We found some heterogenty in the results of some studies but we overcome this problem by using other methods for comparison.Another problem is lack of studies that compare among interventios in some comparative points. Among these studies We found that, as regard postoperative functional outcome and harris hip scoring (HHS), dual mobility arthroplasty(DMA) is higher than Total Hip Arthroplasty (THA). Total hip arthroplasty (THA) is also higher than (BHA) in the score.

Conclusion

As the general population is getting older while staying active, faster and more complete rehabilitation as well as decreased complication rate must be achieved for these patients.
Anterior Cruciate Ligament Reconstruction using Peroneus Longus Tendon Autograft (Systematic Review and Meta-Analysis)
Authors: Khater Ahmad Hany , Hemida Mohamed Amr , Elsayed Ghonim Samir Sabry
Published: July 2024

Background

The ACL is the most commonly injured ligament in the knee, controversy exists about the most suitable graft for ACLR.

Aim of the Work

This study aims to assess the efficiency of PLT autograft as a good alternative graft choice for ACLR and to outline the advantages and disadvantages of its use.

Methodology

We searched the literature through PUBMED, Cochrane library, Medscape, direct science, JBJS and Google scholar with publication date restricted to 10 years range from 2012-2022. English literature of prospective studies only were selected with strict inclusion criteria where human studies undergoing Arthroscopic ACLR using PLT autograft which commenting on clinical +/- imaging outcomes and repeated studies excluded. Eleven studies were included satisfying the predetermined inclusion criteria with total of 564 patients. Four literatures compared ACLR using peroneus longus tendon autograft versus Hamstring tendon,1 literature versus Semitendinosus graft and another versus Patellar tendon. After pooling of collected data from the desired search studies, the relative risk of each of intended outcome measures of interest was calculated and tabulated according to IKDC and AOFAS score.

Results

In 4 literatures, in total, outcomes of 108 PLT versus 129 HT autografts were analyzed with mean follow up 10.5 months, reported little difference was found between the two grafts in favor of PLT autograft, with mean score 95.58 for PLT versus 91.65 for HT. Outcomes of 15 PLT versus 15 semitendinosus autografts were analyzed. PLT autograft gave better clinical and biomechanical outcomes than semitendinosus graft as mean IKDC score was 91.58 for PLT versus 88.37 for semitendinosus graft. Outcomes of 50 PLT versus 50 Patellar tendon autografts were analyzed and reported that PLT autograft has better IKDC score than patellar tendon autograft (96.8 versus 95.1) and lower graft rupture rate (6% versus 10%). In 5 literatures, in total, outcomes of 189 patients, had ACLR using PLT autograft, were analyzed after mean follow up 12.4 months and revealed that mean IKDC score was increased from 64.7 preoperative to 97.8 postoperative. PLT harvest does not appear to affect foot and ankle function to any clinically significant degree with slightly decreased AOFAS score (96.88 ± 4.95).

Conclusion

PLT autograft consider a very promising and ideal graft option for ACLR with excellent functional and biomechanical outcomes. PLT harvest is easy and causes minimal donor-site morbidity.
Short-Term Results after Reversed Total Shoulder Arthroplasty
Authors: Mahmoud Mohamed Mahmoud Shoukry , Samy Abou Elsoud Maged Mohamed , El-Rhaman Amr Ahmed Abd , Mohamed Haytham Abdelazim , Khater Ahmed Hany , Abd El-Wahab Mahmoud Mohamed
Published: July 2024

Purpose

Massive rotator cuff tear, with or without arthritis and proximal humerus fracture non-union or malunion, lead to the loss of center of rotation of shoulder, while anatomical total shoulder arthroplasty does not provide a stable center of rotation, Therefor reversed total shoulder arthroplasty (RTSA) is the suitable method for these indications, as well as in elderly patients with primary glenohumeralosteoarthritis because anatomical total shoulder arthroplasty has the risk of failure either due to loosening of glenoid component or cuff tear. This study aimed to determine the short-term results after RTSA in patients a with massive cuff tear, acute proximal humerus fracture, proximal humerus fracture malunion or non- union, and primary glenohumeralosteoarthritis.

Methods

This one arm clinical trial (interventional study) conducted in Ain Shams University Hospitals included 16 patients who underwent RTSA. Short-term outcomes included constant score, American Shoulder and Elbow Surgeon (ASES) score, and range of motion (ROM). Patients with rotator cuff arthropathy, massive irreparable cuff tear with or without glenohumeralarthritis, elderly patients with acute complex proximal humerus fracture, malunited or nonunited proximal humerus fracture, and patients with glenohumeralosteoarthritis were included. Patients who were aged <50 years were excluded, as well as patients with axillary nerve injury or deltoid muscle dysfunction.

Results

This study included 16 patients, including 8 males and 8 females. The mean age was 64.19 years and the duration of follow up-was 1 year postoperatively. Seven Patients with massive irreparable cuff tear were included, of them, 1 had associated anterior shoulder instability and recurrent anterior dislocation, 3 had a four-part proximal humerus fracture, 2 had fracture dislocation, 2 had proximal humerus fracture non –union, 1had neglected dislocation, and 2 had glenohumeralosteoarthritis. Outcomes were followed using constant and ASES scoring systems, and ROM. The global postoperative gain was statistically significant (p < 0.001). Complication in the form of dislocation occurred in one case that had RTSA after fracture non-union.

Conclusion

Good clinical and functional outcomes were achieved after RTSA, not only for classic massive cuff tear indication, but for other disorders, such as acute proximal humerus fracture, fracture non-union, and primary glenohumeralosteoarthritis. However, the outcomes after irreparable cuff tear were the best among all indications, while fracture non-union had the least improvement in clinical outcomes. Improvements in prosthesis design, surgeon’s experience, and clinical results are necessary to optimize this treatment for many shoulder conditions.
Outcome of Internal Fixation by Cephalomedullary Nail versus Outcome of Bipolar Hemiarthroplasty in the Treatment of Unstable Pertrochanteric Femoral Fractures in Elderly: Systematic Review and Meta-analysis
Authors: Elgebeily Mohamed Abdelmoniem , Ibrahim Mohammed Ali , Abdelwahab Ibrahim Ibrahim
Published: July 2024

Background

Pertrochanteric femoral fractures are extracapsular metaphyseal fractures of proximal femur that involve the region between the femoral neck and shaft. Intertrochanteric femur fractures, the most common type of fragility fractures in the elderly, account for 55% of proximal femoral fractures. Intertrochanteric femur fractures have high fatality and disability rates, resulting in a huge burden on the economy and on society.

Objective

To compare the advantages and disadvantages of the PFN and BHA to provide reliable evidence for clinicians in selecting the optimal treatment for unstable pertrochanteric fractures.

Patients and Methods

This systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines.

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2022.

Data Extraction

Data were independently extracted by two reviewers and cross-checked.

Results

This study included 12 samples which recruited 1019 patients with unstable intertrochanteric fractures, form which 515 patients underwent bipolar hemiarthroplasty (BHA) and 504 patients underwent proximal femoral nail (PFN). No significant difference between BHA and PFN in operative time and post-operative hospital stay was found. Intra-operative blood loss and incidence of blood transfusion was higher in BHA compared with PFN. HHS was higher after PFN than after BHA. Patients underwent PFN required larger period for partial weight bearing compared with who underwent BHA. There were no statistically significant difference between both groups regarding postoperative mobility scores, reoperation rate, incidence of infection and limb length alteration. The overall mortality rate risk ratio revealed that the incidence of mortality was higher after BHA than PFN.

Conclusion

Both PFN and BHA can be used in managing fractures of the Intertrochanteric in elderly patients. PFN establishes itself as a better modality than BHA due to lower postoperative mortality and better functional outcomes. BHA should ideally be reserved for lower life expectancies and those requiring immediate weight bearing patients.
Bone Transport through Induced Membrane Technique versus Conventional Bone Transport Technique in Management of Bone Defects of Lower Limbs
Authors: Thakeb Mootaz Fouad , El Gebeily Mohamed Abdel Monaem , El Kersh Mohamed Ahmed , Baraka Mostafa Mohamed , Khairy Kozman Michael Amir
Published: July 2024

Objectives

To assess whether Bone transport through induced membrane (BTM) has better outcomes regarding docking site union and infection recurrence than conventional bone transport (BT) or not in the treatment of infected lower limb long bones defects.

Methods

A prospective randomized controlled study in a single institution was conducted. A total of 30 patients with infected non united fractures of long bones of lower limbs were divided into 15 patients (10 femurs, 5 tibias) treated by BTM and 15 patients (3 femurs,12 tibias) treated by BT. The outcome measures includes external fixation time (EFT), external fixation index (EFI), docking time (DT), bone and functional outcomes evaluated by the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system, postoperative complications evaluated by Paley classification and number of additional operations.

Results

The mean docking time (DT) was significantly lower in BTM group in comparison to BT group (3.67 ± 0.82 months vs 4.80 ± 0.86 months respectively) (p value 0.001). Docking site nonunion and infection recurrence were significantly lower in BTM group in comparison to BT group (0% vs 40% respectively) (p value 0.02) and (0% vs 33.3% respectively) (p value 0.04). Mean number of additional operations per patient was significantly lower in BTM group in comparison to BT group (0 vs 0.80 ± 1.08 operations respectively) (p value 0.01)

Conclusion

Both BTM and BT achieved satisfactory postoperative bone and functional outcomes in patients with infected long bones defects of lower limbs, while BTM had significantly faster docking site union, lower incidence of postoperative complications including docking site nonunion and infection recurrence rates and lower number of additional operations needed at the expense of 2 staged procedure in comparison to BT.
Minimally Invasive Sacroiliac Joint Fusion: A Systematic Review and a Meta-Analysis
Authors: Abouelela Amr A K H , Sallam Ahmed Mohammed , Mohamed Abdelkader Amr Salah
Published: July 2024

Background

Low back pain (LBP) is a worldwide health problem and one of the top three causes of health deterioration in affluent countries. After the common cold, LBP is the second most prevalent reason for visits to primary care providers. Aside from high levels of disability and lost income, LBP increases the risk of falls in the elderly, which can result in hip and/or spinal fractures, increasing morbidity and mortality in this vulnerable group.

Materials and Methods

Application of inclusion and exclusion criteria to study Abstracts yielded 9 articles. A total of 390 studies were identified from the database search. After review, a total of 9 studies consisting of 1224 patients with SIJF were selected.

Results

A total number of 1224 patients with SIJF were selected. The 9 studies ranging from 2012 to 2019. Among the 9 studies were 4 randomized control trials and 2 studies were retrospective studies. Among the patients, 407 males and 817 females. The age ranged from 24 years to 81 years among the 9 studies. The follow-up duration ranged from 6 months to 2 years among our studies.

Conclusion

The meta-analysis performed in this systematic review demonstrated that patients who fail conservative therapy and have a positive diagnostic SI joint block may clinically benefit from minimally invasive sacroiliac joint fusion using a lateral trans-articular approach. Sacroiliac joint fusion appears to be a satisfactory procedure for alleviating low back pain.
Outcome of Flexible Intramedullary Nailing versus Plating in Treatment of Diaphyseal Femur Fractures in Paediatrics: Systematic Review and Meta-analysis
Authors: Saad Torkey Mohamed Eid , Goda Ayman Hussein , Elhusseiny Karim Tarek
Published: July 2024

Background

Pediatric femoral fractures are the most the common long bone fracture in children, with one third of these occurring between ages 5 to 12. These injuries are usually the result of road traffic accidents, sports and non-accidental injury. Different modalities exist for managing these fractures, often stratified according to the age of the patient.

Aim of the Work

The aim of this work is to provide a complete overview of the optimal surgical treatment of diaphyseal femur fractures in children by evaluating and comparing the clinical and functional outcomes of flexible intramedullary nailing versus plating for such fractures.

Patients and Methods

This review followed the Cochrane Handbook's standard methodology and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- analyses (PRISMA) statement guidelines.

Result

In patients undergoing flexible nailing, the surgical variable data found this treatment modality to be superior in terms of certain operative features: shorter operative duration times (p = 0.00001), smaller volumes of estimated blood loss (p = 0.00001). There was no difference regarding length of hostital stay (p = 0.59). This suggests that flexible nailing may offer increased safety to patients in terms of duration of anesthesia, volume of blood loss, and cost of surgery when compared to plating. However, Secondary outcome analysis also found a statistically significant increased risk of malunion (p = 0.002) and metalwork irritation (p = 0.00001) when using FIN compared to plating techniques. There was no difference regarding risk of infection (p = 0.53) and developing leg length discrepancy (p = 0.44).

Conclusion

Options for stabilization and fixation in this age group include flexible nailing, plating (open or sub-muscular), external fixation, or hybrid techniques.
Valgus Osteotomy versus Arthroplasty for Ununited Femoral Neck Fractures: A Systematic Review
Authors: El Dayem Sherif Mostafa Abd , Mohsab Ahmed Mohamed , Mohaseb Ahmad Mohamed
Published: July 2024

Background

Fractures of the neck of femur in young adults tend, unlike their counterparts in older people, to be a relatively higher energy injury and require timely and meticulous diagnosis and management. Anatomical reduction and stable internal fixation are essentials for achieving the goals of treatment in this young population allowing preservation of the femoral head while minimizing rates of non-union and osteonecrosis.

Aim of the Work

The aim of this systematic review is to collate evidence from comparative studies to look for significant differences between valgas osteotomy &arthroplasty in non united femoral neck fractures in < 50yr old patients.

Patients and Methods

Only studies with Randomized controlled trials and comparative non controlled trials had been included. The study included Valgas osteotomy & arthroplasty for ununited femoral neck fractures. Application of inclusion and exclusion criteria to study Abstracts yielded 11articles. The full-text articles for these 40 studies were then reviewed and subjected to our inclusion criteria. A total of 11 articles were eligible for final systematic review.

Results

There was improvement in Harris hip score in all included studies ranged from 79.8 to 95. In comparison between two groups, groups with THA had significantly higher Harris hip score than osteotomy score. In this review reoperation and infection were common among osteotomy group than total hip arthroplasty group.

Conclusion

Although non-union problems following femoral neck fractures are common, the primary objective is to preserve the hip, by seeking alternative methods, specifically in young patients, and considering that the femoral neck can usually remain viable. Therefore, alternatives such as valgus osteotomy, which enables union by solving mechanical issues and allows patients to live with their own bones, have long been in use and successful Valgus intertrochanteric osteotomy is the treatment of choice for active patients aged less than 50 years with a nonunion of a femoral neck fracture. This technique requires precise preoperative planning and intraoperative skill. Patients should be warned of the risk of avascular necrosis, as well as the difficulty in performing revision arthroplasty in this setting.