bluuebunny/crossref_metadata_2025 huggingface dataset:
Toll like receptor 9 (TLR 9) expression in peripheral blood mononuclear cell (PBMCs) from treated and untreated Grave’s disease patients
Authors: Okba Ashraf M , Shaheen Rasha Y , Mostafa Gehan M. H , Ali Hanan M , Abo El Fadle Sylvia W , El-Badry Mai A
Published: October 2021

Background

It is well known that Autoimmune thyroid disease is multifactorial with multiple genetic and environmental factors, immune malfunction also incriminated in the development of this disease, The exact pathogenesis of this disease remains unclear despite the fact that the production of autoantibodies destroys self-tolerance and agitate the adaptive immune system. Our study will answer the question is there a difference in Toll like receptor 9 (TLR 9) expression in peripheral blood mononuclear cell (PBMCs) from Grave’s disease patients.

Objective

to measure TLR9 percentage expression on peripheral blood mononuclear cells in patients with Graves’ disease.

Methods

60 subjects were included in this study; 30 with Graves’ disease and 30 healthy individuals as control group. All the patients were subjected to the following: Full history, clinical examination, thyroid functions, Thyroid ultrasound, Radioisotope thyroid scan: to assess uptake of thyroid gland and Toll like receptor 9 (TLR 9) percentage expression on peripheral blood mononuclear cells will be analyzed using flow cytometry technique.

Results

The present study proved that patients with Graves’ disease had higher levels of percentage expression of TLR 9 on peripheral blood lymphocytes.

Conclusion

percentage expression of TLR9 on peripheral blood lymphocytes is higher in Graves’ patients.
Causes, Complications and Pattern of Hemodialysis in Egypt
Authors: Elsaid Tamer W , Abdulgawaad Mostafa A , Ali Fatma A. Nasser S
Published: October 2021

Background

There is a gap between evidence base and current practice in hemodialysis pattern which is different from a country to another due to different economic levels and organization of health. these gaps include many things such as causes and co-morbidity modality of hemodialysis medication given.

Methods

This cross sectional study was carried out on 500 end Stage renaldisease (ESRD)in Egypt

All patients selected were subjected to full history, examination, medical record which included iron study HGB, bone study, erythropoietin. vitamins,HD prescription, causes and complications of HD.

Results

HD pattern in Egypt agrees with the international guidelines and other countries except age(less than USA), bicarbonate as buffer for HD (acetate still used) HGB level is 9.2 gm./dl(target 11-12), using sevelamer as phosphate binder less than usual percent of others, work status for HD pts., is higher than others, routine iron investigations and routine adequacy of HD

Conclusion

there are increased prevalence of dialysis patients in Egypt and few difference in the pattern of HD with international guidelines
A study of procalcitonin and c-reactive protein in chronic h.pylori gastritis and it’s relation to severity of the disease
Authors: Makhlouf Mohamed A. M , Salama Mohamed M , Elessawy Hagar A. A , Abd El-Hady Ramy M
Published: October 2021

Background

Gastritis is an important premalignant lesion and recent studies suggested a production of inflammatory cytokine-like C-reactive protein during gastritis. This study aimed to determine any relationship between high sensitive Creactive protein (hs-CRP) and inflammation activity among patients with gastritis.

Aim and objectives

the aim of the study is to compare the levels of procalcitonin and CRP in serum between positive and negative H. pylori chronic gastritis, to correlate their levels with the severity of inflammation of chronic gastritis[h.pylori related and non h.pylori related]and to suggest any effect of different regimens of treatment and their levels in serum.

Subjects and methods

This is a Cross sectional comparative study, was carried out at Internal Medicine medicine departments of Ain Shams university hospitals, from September 2019 till March 2020,on 75 patients divided into 3 groups: (Group A); positive H. Pylori chronic gastritis,(Group B); negative H. Pylori chronic gastritis,(Group C); normal control group.

Results

There was positive highly significant correlation between H. Pylori severity and each of CRP and Procalcitonin where (r = 0.929; P < 0.001) and (r = 0.928; P < 0.001) respectively.

Conclusion

PCT and CRP were effective markers for primary diagnosis, as well as eradication follow-up after therapy, when they were used in parallel with conventional diagnostic methods.
Evaluation of the Role of Hyaluronic Acid as a Potential Marker for Diagnosis of Non-Alcoholic Fatty Liver Disease
Authors: Awad Emad A , ElGhandour Ahmed M , Mansour Ahmed M , AbdelHamid Riham H
Published: October 2021

Background

Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide, ranging from simple steatosis and nonalcoholic steatohepatitis (NASH) to liver cirrhosis, with its complications including hepatocellular carcinoma (HCC).

Aim of the Work

to evaluate the efficacy and reliability of Hyaluronic Acid as a potential noninvasive biomarker for diagnosis and prognosis of NAFLD and to compare it with the traditional noninvasive techniques and if it can replace liver biopsy.

Patients and Methods

This cross-sectional study was conducted on 63 subjects from the Gastroenterology and Hepatology Department of Ain Shams University Hospital. They were divided into three different groups as following: a healthy control group, fatty liver and nonalcoholic steatohepatitis (NASH). All patients and controls were subjected to routine laboratory tests and serum Hyaluronic acid test.

Results

There were high statistical significant differences between groups as regard INR. Regarding to liver functions, there was a high statistical significant difference between groups as regard AST and ALT ,Bilirubin and Albumin.. Comparison between groups regarding to RBS, there was high statistical significant difference between groups as regard RBS. Comparison between groups regarding to lipid profile, there was high statistical significant difference between groups as regard LDL and cholesterol. Regarding to APRI and Fib4, there was high statistical significant difference between groups as regard APRI and Fib4. Regarding to H.A, there was high statistical significant difference between groups as regard H.A. The study shows that there is non-significant correlation between either APRI or Fib4 and H.A in fatty liver, and there is also nonsignificant correlation either APRI or Fib4 and H.A in NASH.

Conclusion

Hyaluronic Acid can be reliably used as an accurate and specific noninvasive biomarker for the diagnosis of Nonalcoholic fatty Liver Disease and staging of the severity of disease compared with the traditional known noninvasive scores
Serum microRNA-122 Levels in Egyptian Patients with Chronic Hepatitis C virus Genotype 4 Infection before and after treatment with Direct Acting Antiviral Drugs
Authors: Helal Essam Mohammad Bayoumy , Sayed Moataz Mohammad , Aziz George Tari Magdy , Anwar Christina Alfons , Agwa Sara Hassan , Mostafa Elwakeel Sameh
Published: October 2021

Background

Viral hepatitis was estimated to be the 7th leading cause of mortality globally. About half of this mortality is attributed to HCV, a primary cause for liver fibrosis, cirrhosis and cancer. The recent development of highly efficacious oral DAAs provides opportunities for reducing HCV disease burden and its onward transmission, with the potential for eliminating this blood-borne virus as a public health concern. WHO has recently formulated the ‘Global Health Sector Strategy on Viral Hepatitis, 2016– 2021 with service coverage targets to eliminate HCV as a public health threat by 2030.

Objective

To asses the possible relation of miRNA 122 to HCC development after HCV therapy with direct antiviral drug.

Patients and Methods

Previous studies suspect that HCV therapy by DAAS may increase risk of HCC so the aim of our study is to evaluate miR-122level at end of HCV treatment by DAAS and compare the results with miR-122level in HCC patients. The study was performed as a case control study in Ain Shams University hospital and Suez Canal authority hospital (Outpatient Clinic), at Ismailia Egypt in the period between Augusts to October 2018.

Results

These results revealed an effect of treatment by DAAs in HCV infected patients leading to miRNA 122 reduction and this may be related to hepatocarcinogenesis. However, further studies on a large patients number are needed to clarify this point and determine the diagnostic and possible therapeutic value of miRNA 122 in HCV infected patients.

Conclusion

Baseline MiR-122 level at cutoff value ≤0.26 was significantly lower in HCC patients than chronic HCV patients and normal controls, with a sensitivity of 80%, a specificity of 70%. MiR-122 was significantly reduced at end of HCV therapy with DAAs and became similar to values in HCC patients. Whether this observed reduction is mechanistically related to hepatocarcinogenesis is still a possibility, to be clarified in furtur large scale studies. The reduction of MiR-122 at the end of HCV therapy with DAAs was significantly observed in (F3,F4) patients than those with early fibrosis stages(F1,F2).This again gives a possible explanation of HCC development in HCV patients with advanced fibrosis(cirrhosis)and raises the question about the diagnostic and therapeutic value of miRNA 122 (and possibly other miRNAs)in the management strategy of HCV infected patients.
Evaluation of Serum Omentin-1 Levels in Chronic Kidney Disease Patients with and without Type 2 Diabetes Mellitus
Authors: Mohammed Magda Shukry , Abd Elbaky Rania Sayed , Ali Hanan Mahmoud , Naguib Tahani Abdelsalam
Published: October 2021

Background

Omentin-1 a new anti-inflammatory adipokine has been identified as a major visceral (omental) secretory adipokine which plays important roles in glucose homeostasis, lipid metabolism, insulin resistance and diabetes.

Objectives

This study aimed to investigate the level of Omentin-1 in chronic kidney disease patients with and without type 2 diabetes mellitus.

Methods

The study included 70 patients who further subdivided into three subgroups (20 T2DM, 25T2DM+CKD, 25CKD) and 20 healthy subjects formed the control group. They subjected to full clinical examination, weight, height, waist and hip circumference and BMI was calculated.Lipid profile, omentin-1, kidney function test, UACR, and HbA1c were measured.

Results

Serum omentin-1 level was lower in all patient groups compared to healthy control. It’s level was lower in groups with T2DM than CKD only group. It had a negative correlation with HbA1c, cholesterol total, TGs, LDL-c and e-GFR, and a positive correlation with s.creatinine, UACR, BUN, HDL-c. The best cut off point of serum omentin-1 was  < =330 ng/ml to differentiate group 3(T2DM+CKD) from control group using ROC curve analysis.

Conclusion

The results of the present study suggest that diabetes mellitus may be associated with lower omentin levels in CKD population .
Ascitic procalcitonin as a diagnostic and prognostic marker of spontaneous bacterial peritonitis
Authors: Salem Amira Ahmed , ElNakeep Sarah Abd ElKader , ElGhandourl Ahmed Mohamed , Mohamed Mohamed Ahmed Ahmed
Published: October 2021

Background

SBP is a condition that requires a high index of suspicion, rapid and accurate diagnosis in addition to prompt and effective therapy. It is also characterized by a high recurrence rate within one year of the 1st episode.

Objective

Evaluation of ascitic fluid procalcitonin as a possible diagnostic and prognostic marker for spontaneous bacterial peritonitis and to study its role in diagnosis of SBP with no increase in the neutrophil count (where neutrophils in the ascitic fluid are less than 250 per ccm while the culture is positive).

Patients and Methods

Study was conducted at Hepatology and Gastroenterology Department in Ahmed Maher Teaching Hospital and Internal Medicine Department in Ain Shams University from January 2019 till July 2019. Total number of 50 patients with cirrhotic ascites entered this study were divided into three groups: Group A (patient group): 20 patients with SBP as diagnosed by 250 neutrophils or greater per cmm of the ascitic fluid as present in the guidelines. Group B (patient group): 20 patients with criteria suggestive of SBP (abdominal pain, fever, liver function deterioration, leukocytosis in the CBC with no other localization for the infection), but shows neutrophil count in the ascitic fluid less than 250 i.e not diagnostic by itself. Only Patients with positive culture will be included in this group. Group C (control group): 10 patients with ascites,but no evidence of SBP (symptomatic or laboratory) as the control.

Results

Ascitic fluid procalcitonin level was statistically significant higher in both groups A&B (SBP group) than group C (non-SBP group). As regards Group A VS Group B+ Group C: The cutoff point is 520 (pg). Its sensitivity is 95%. Its specificity is 53.3%. The AUC is 0.633. The positive predictive value is 57.6%. The negative predictive value is 94.1%. Regarding Group B VS Group C: The cut-off point is 300 (pg). Its sensitivity is 85%. Its specificity is 70%. The AUC is 0.823. The positive predictive value is 85%. The negative predictive value is 70%.

Conclusion

Ascitic fluid procalcitonin had high sensitivity and specificity in diagnosis of SBP. Procalcitonin is valuable in diagnosis and prognosis of SBP. Procalcitonin is more useful as inflammatory marker than in infections
Fetuin A and abdominal aorta calcification in hemodialysis patients
Authors: Kamal Osama Mahmoud , Elsaeed Tamer Waheed , mobdy Ashraf Hassan Abdel , Askar Mohammed Abdel Halim
Published: October 2021

Background

Patients with chronic kidney disease (CKD), especially those on regular hemodialysis, have unique Mineral and endocrine disturbances. Vascular calcification is a dynamic process influenced by bone kidney disease, as well as an imbalance between promoters and inhibitors of extra-osseous bone formation. Calcification is defined as the accumulation of calcium salts in tissues. This is a specific type of mineralization, which in contrast to calcification involves the deposition of any mineral.

Aim of the work

To determine abdominal blood vessels calcification in hemodialysis patients and its relation to fetuin A plasma level.

Patients and Methods

This study included 60 patients (30 case and 30 control) admitted to Mansoura university hospitals. The patients were included in this study, all are End-stage renal disease (ESRD) patients on regular hemodialysis (HD) (4 Hours- 3 times weekly) for at least 3 month after obtaining informed conset from all patients).

Results

Our study showed non significant negative correlation between fetuin A and aortic calcium score .

Conclusion

High serum fetuin-A level was shown to be protective factor against vascular calcification and is associated with lower severity of abdominal aortic calcifications in regular hemodialysis patients.
Study of Effect of Whitening Creams on Serum Basal Cortisol level In Egyptian Females
Authors: Eid Yara Muhammed , Ahmed Iman Zaky , Nasr Merhan Samy , Mansour Hany Khairy , Baqraf Mohammed Omar Awadh , Ismail Samya Al Tohamy
Published: October 2021

Objective

The aim of the present study is to evaluate the relationship between practice of whitening creams (Topical Corticosteroids) and serum cortisol level in a sample of healthy females at Ain- shams University Teaching hospital.

Background

Topical corticosteroids (TCs) are widely used as depigmenting agents alone or in combination with other fairness creams. Secondary adrenocortical insufficiency occurs due to deficiency of corticotropin (adrenocorticotropic hormone) [ACTH] in the pituitary gland. With low levels of corticotropin, cortex layer in the adrenal gland is not sufficiently stimulated to release adequate amount of cortisol. Excessive glucocorticoid therapy is the primary cause of adrenocortical insufficiency.

Methods

we recruited 45 subjects practice whitening creams (TCs) for three months or more; matched with a healthy control group consists of 45 participants. Early morning basal serum cortisol level (8:00 am) done by one-step competitive immunoassay using Beckman Coulter device. Cortisol ELISA Kit provided by CALBIOTECH, Inc (Co_103S).

Results

Early morning serum cortisol level was statistically insignificant among subjects practice whitening creams in combination with TCs vs. healthy controls (p value 0.307). However, there were 7 out of 45 participants in the study group (15.6%) had low serum cortisol level (<5ug/dl) with highly statistically significant difference regarding whitening creams usage methods. In comparison and data analysis between subjects of the study group regarding practice duration, used quantity, application frequency, and method of exposure, there was high statistically significant difference between subjects with normal cortisol level vs. subjects with low cortisol level (p value <0.001). There were, no significant difference found regarding BMI, and arterial blood pressure between study group and controls.

Conclusion

Whitening creams abuse especially high potency TCs is a common phenomenon that may induce several local and systemic complications including adrenal gland insufficiency.
Prevalence of problematic social media use among residents and teaching assistants in Ain Shams University Hospitals and faculty of medicine and its relationship to emotional distress
Authors: Allam H , ELNahas G , El-Habiby M , Elkholy H
Published: October 2021

Background

Social media use becomes pervasive and universal among young adults including medical personnel. Furthermore, it become established that more frequent use of the social media is associated with negative psychological well-being, anxiety which represents the second leading cause of disability among all psychiatric disorders and depression which represents the single largest contributor to global disability according to the World Health Organization.

The Aim of this study

To analyze the relationship between the use of social media, stress level, anxiety and depression among residents in Ain Shams University Hospitals (ASUH) and academic demonstrators in faculty of medicine.

Patients and Methods

This is an observational cross-sectional study, Conducted in Ain Shams University hospitals (ASUH), we included 200 of staff and medical school academics in faculty of medicine, starting from February 2018 till August 2019.

Results

33 participants showed average social media use representing 16.5% while 167 participants showed problematic social media use representing 83.5%. 11 participants showed low stress levels representing 5.5%, 127 participants showed moderate stress levels representing 63.5% while 62 participants showed high stress levels representing 31%.

Conclusion

Social media use by clinicians is widespread, especially by younger clinicians for personal and reference purposes. Use of multiple SM platforms is independently associated with symptoms of depression and anxiety, even when controlling for overall time spent in their use.
Validity of Skeletal Muscle Ultrasound in Assessment of Suspected Limb Girdle Muscular Dystrophy Patients
Authors: Ibrahim Rasha M , Hamdy Haitham M , Mohammed Amr A , Elsadek Ahmed M , Bassiouny Ahmed M , Fahmy Nagia A
Published: October 2021

Background

Limb-girdle muscular dystrophies (LGMDs) are a clinically and genetically heterogeneous group of disorders characterized by progressive muscle weakness and degenerative muscle changes. Studies have shown that ultrasound can be useful both for diagnosis and follow-up of LGMDs patients.

Objectives

This study aims to measure the sensitivity and the specificity of muscle ultrasound in assessment of suspected limb girdle muscular dystrophy patients.

Subjects and Methods

This cross-sectional descriptive study was conducted on Fifty-five patients with suspected LGMD from neuromuscular unit, myology clinic, Ain Shams University hospitals and eight healthy subjects. Age was above 2 years. Both sexes were included in the study. They underwent real-time B-mode ultrasonography performed with using Logiq p9 General Electric ultrasound machine and General Electric 7-11.5 MHZ linear array ultrasound probe. All ultrasound images have been obtained and scored by a single examiner and muscle echo intensity was visually graded semiquantitative according to Heckmatt's scale. The examiner was blinded to the muscle biopsy results and clinical evaluations.

Results

Statistical analysis revealed that the diagnostic performance of muscle US (Heckmatt’s score) in LGMD is most sensitive when calculated in all examined upper limb and lower limb muscles, followed by lower limb muscles alone. US of upper limb was found to be the least sensitive.

Conclusions

Muscle ultrasound is a practical and reproducible and valid tool that can be used in assessment of suspected LGMD patients.
Intra-Articular Injections of Platelet-Rich Plasma versus Hyaluronic Acid in Treatment of Knee Osteoarthritis (Systematic Review and Meta-analysis)
Authors: El-beltagy Atef Mohamed , Zakaria Zeiad M , Ibrahim ; Mohamed Abdel-Samei
Published: October 2021

Background

Although PRP is one of the options in the management of knee OA, its effectiveness and wide application is still controversial. Therefore, we conducted the present systematic review and meta-analysis to compare the safety and effectiveness of PRP versus HA injection for knee OA.

Objective

The purpose of this study is to compare between the efficacy of intra-articular injections of Platelet-Rich Plasma versus Hyaluronic Acid in treatment of knee osteoarthritis.

Methods

We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists.

Results

The overall effect favoured PRP over HA for WOMAC function score, WOMAC pain score, WOMAC stiffness score, and WOMAC total score; mostly 6 and 12 months after treatment. According VAS score, we found that the overall effect favoured PRP over HA at 12 months only. In contrary, the overall effect did not favour PRP over HA for VAS score at 3 and 6 months. PRP is superior to HA for IKDC scores at 6 and 12 months with similar results at 3 months.

Conclusion

Intra-articular PRP injection is more effective in terms of pain relief and function improvement at short-term follow-up in the treatment of knee OA than HA, and there is no significant difference in the risk of adverse events between PRP and HA. A randomized controlled trial with larger group sizes is necessary to find the predictors of the response to PRP and HA intra-articular injection.
Comparison of Surgical Outcomes between Cortical Bone Trajectory and Conventional Pedicle Screw Trajectory for Lumbar Degenerative Spondylolisthesis (systematic review of literature)
Authors: Khattab Mohamed Fawzy , Kamal Mostafa Atef , Zaher Mbbch Naser Hussein
Published: October 2021

Background

Pedicle screw fixation the gold standard for lumbar spine stabilization. Pedicle screw has fixation offers multiple advantages, allowing superior correction of spinal deformities, and reduced rates of loss of non-union. Cortical Bone Trajectory (CBT) is a new technique in which screws follow a caudal-to-cephalad path in the sagittal plane and a medial-to-lateral directed path in the transverse plane. CBT is reducing operative and post-operative complications and has high fixation strength.

Purpose

To Compare the clinical outcomes between CBT and traditional trajectory (TT) in surgical management of degenerative spondylolisthesis.

Materials and Methods

A comprehensive electronic search in Pubmed, MEDLINE and Chocrane library databases, Google scholar and Research gate for articles that published between 2009 to 2020 using these keywords: Cortical bone trajectory, Cortical bone trajectory-pedicle screw, Pedicle screw.

Results

The majority of literature suggests that the CBT technique results in similar or decreased postoperative back and leg pain compared to TT. Regarding the disability ODI and the operative time showed no significant differences between the CBT and TT. Radiographic outcomes between both studies show no statistical difference in fusion rates and vertebral slippage. Intraoperative blood loss was significantly less with CBT compared to TT.

Conclusion

there is no widely accepted consensus regarding comparison of clinical outcomes and complications between the CBT and TT procedures. Generally, indications for CBT and TT are similar between most studies, especially for common pathologies resulting in spondylolisthesis.
Recent Methods of Neck Femur Fixation A Systematic review and meta-analysis
Authors: Eid Ahmed Salem , Mohasseb Ahmed Mohamed , El-Bahnasy Ramy Mohamed Mohamed
Published: October 2021

Background

Femoral neck fractures in adults younger than age 50 years are uncommon and often the result of high energy trauma. They account for only 2-3% of all femoral neck fractures. Femoral neck fractures are associated with aging and osteoporosis and can occur after relatively trivial trauma in elderly patients. femoral neck fractures are associated with higher incidences of femoral head osteonecrosis and nonunion. Fixation options include cannulated screws, non parallel cannulated screws, medial augmentation plate, and fixed angle femoral neck fixation implants. A systematic review of literature done to evaluate which technique is better.

Methods

After literature search thirteen articles were found and were reviewed to evaluate final outcome of fixation of neck femur fractures by cannulated screws, non parallel cannulated screws, medial augmentation plate, and fixed angle femoral neck fixation implants.

Results

After evaluation of all studies the incidence of nonunion, osteonecrosis of femoral head, implant failure & revesion surgery is lower in comparing Targon plate with multiple cannulated screws while we need further studies for application of non parallel screws and medial plate.

Conclusion

Targon plate recorded low incidence of complications in the final outcome in comparison with multiple cannulated screw while we need further studies for application of Non parallel screws and medial plate.
Surgical Outcomes and adverse effects for Minimally Invasive versus Open Posterior Lumbar Interbody Fusion
Authors: Wafa Mohamed Abdelsalam , Elkhateeb Tameem Shafik , Abdelhameed Reda Shaaban
Published: October 2021

Background

Minimal invasive techniques for lumbar interbody fusion is a novel surgical procedure developed to reduce approach-related morbidity associated with traditional open techniques.

Objective

To determine the clinical comparative effectiveness and adverse event rates of posterior minimally invasive surgery (MIS) compared to open transforaminal or posterior lumbar interbody fusion (TLIF/PLIF) for early and late outcomes by using the visual analogue scale for back pain (VAS–back) and the Oswestry Disability Index (ODI).

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2018.

Data Extraction

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

Conclusion

MIS techniques for lumbar interbody fusion is a safe alternative for classic open procedures but due to the limited number of the included RCTs, more well-designed multicenter RCTs with larger sample sizes and long-term follow-up are still needed to compare the clinical efficacy and safety of both techniques.
Comparative Study between Surgical Excision of Radial Head Fracture versus Arthroplasty, a Systematic Review of Literature
Authors: Megied Wael S. Abdel , Khaled Ahmed M , Rehan Waleed M
Published: October 2021

Background

Radial head fracture is the most frequently diagnosed fracture of the elbow in adults. The radial head is a secondary valgus stabilizer of the joint and it is involved in transmission of axial force load through the elbow during flexion. It is also a varus and external rotatory constraint.

Aim of the Work

to compare the functional outcome between excision of head radius and Arthroplasty in surgical management of radial head fractures (Mason types III and IV) and to assess the complications of both techniques.

Patients and methods

This systemic review included subjects suffered comminuted radial head fracture Mason type III or type IV treated by radial head excision or arthroplastyin the last 14 years from 2004 till 2018. Results: The database search identified 152 potentially relevant articles. Abstracts have been analyzed following inclusion and exclusion criteria and a total of 17 papers were selected for the present review. Most of retrospective studies on metal radial head prosthesis have been published in the last ten years in comparison to a lack of studies for radial head excision in the last two decades. Moreover, few articles on comparison of the two surgical techniques have been found. Because of heterogeneity in level of evidence, surgical technique, type of implants, and rehabilitation protocol, we did not perform statistical data analysis.

Conclusion

No clinical differences between radial head excision and arthroplasty as both methods are considerable regarding complication on long & mid-term follow up and functional outcome assessed by DASH, VAS, MEPS & ROM.
Different Modalities of Management of Early and Late Traumatic Soft Tissue Defects of The Hand
Authors: AbdelAliem Moustafa Ahmed , Estawrow Mina Agaiby , Almajeed Shaaban Mohamed Abd , El-maraghy Abdelrahman Mohamed
Published: October 2021

Background

Hand injuries contribute to financial losses in terms of treatment, time off work and loss of job. Hand injuries are rising and therefore increasing awareness and improving management of hand injuries are warranted in low resources settings.

Objective

A systematic review and meta-analysis of different modalities of management of early and late traumatic soft tissue defects of the hand.

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2018.

Data Extraction

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

Conclusion

Soft tissue defects of the hand can be reconstructed effectively with multiple options that can restore function in addition to stable coverage. The use of grafts with several local and regional flaps have been identified including advancement flaps, rotation flaps in cases where local tissue is available and healthy. Which have the ability to match colour and texture of the recipient site, coverage of vital structures with minimal donor site morbidity. The preferred approach is the simplest method which can provide the most stable coverage. A careful selection of flap choice for coverage of a hand defects should take into account the anatomy and functional requirements of the defect site, the patient’s health condition and the surgeons experience to ensure good functional and aesthetic outcomes for the patients.
Shear Wave Elastography in Assessment of Liver Fibrosis
Authors: Abdulateef Alaa Kanaan , Gamrah Sherif Abou , Hassan Ayman Hassan , Ragheb Samar Ramzy
Published: October 2021

Background

Liver fibrosis is major medical issues in patients with chronic hepatitis C (CHC). It may lead to cirrhosis, hepatocellular carcinoma (HCC) and liver-related death. Therefore, assessing the degree of fibrosis in patients with chronic liver diseases, especially before the advanced stage, is clinically important to allow early care and prevent fatal liver disease.

Objective

The plan was to do shear-wave Elastography after fibroscan (TE) in order to assess the stiffness of the liver, detect the changes occurred in hepatitis C patients and measure diagnostic accuracy of 2D- SWE by using TE as reference standard.

Methods

A cross-section study included 30 persons with positive hepatitis C. They were referred to Radiology department at National Hepatology and tropical medicine research institute.

Results

Our study included (30) patients who have hepatitis C positive, their ages ranged from (18) years old to (60) years old with mean SD of 52.97 ± 9.43. They were 17 females (56.7%) and 13 males (43.3%). Different liver fibrosis stages were observed by 2D-SWE as following: (FO) 4 patients (13.3%), (Fl) 4 patients (13.3%), (F2) 9 patients (30.0%), (F3) 10 patients (33.3%), (F4) 3 patients (10.0%). While TE (fibroscan) shows (FO) 6 (20.0%), (Fl) 3 patients (10.0%), (F2) 7 patients (23.3%), (F3) 8 patients (26.7%) (F4) 6 patients (20.0%). Our study showed that the relation between TE (fibroscan) and SWE finding had positive correlation of most patients with liver fibrosis with (p-value 0.006 and r-value 0.487). Because the impoltant of significant fibrosis for initiate antiviral protocol therapy, 30 patients classified into FO—FI (non-significant liver fibrosis) versus F2—F4 (significant liver fibrosis). Our study show significant discrimination was found between no/mild fibrosis (FO-FI) and significant fibrosis (F2-F4), shows the sensitivity of SWE in detection of significant fibrosis results is 95.2% and the specificity is 77.8%, PPV 90.91 %, NPV 87.5% and the accuracy 90.0% with cutoff value >5.7kPa.

Conclusion

SD-SWE is accurate in prediction significant fibrosis (2F2), Thus is expected to overcome the limitation of TE as a reliable method to assess fibrosis induce by hepatitis.
Role of Computed Tomography and Magnetic Resonance Imaging in detecting the Prevalence of inner ear anomalies among cochlear implant candidates
Authors: Zaher Alaa Nasser Hussain , Abd El Aziz Tougan Taha , Abdelrahman Ahmed Samy
Published: October 2021

Background

Hearing loss management using cochlear implants in patients with inner ear anomalies has long been discussed in the otology community. Magnetic resonances imaging (B,/IRI) and Computed tomography (CT) play important roles in the preoperative assessment of inner ear abnormalities such as cochlear nerve deficiency and variant anatomy as these abnormalities may not only affect the decision of the implantation procedure or the patient's prognosis regarding auditory improvement, but also the risk of complications.

Objective

To examine the prevalence of inner ear anomalies among cochlear implant recipients in patients with congenital sensorineural hearing loss among the pediatric age group in the Demerdash hospital, Ain Shams university using High resolution computed tomography (HRCT) and MRI imaging.

Methods

A retrospective descriptive study over the course of 9 months that included all patients that are candidates for cochlear implant referred to the Radiology department, Ain Shams University Hospitals for a preoperative imaging in the form of CT and VIRI scans.

Results

CT and MRI scans of 33 patients who had congenital hearing loss and were candidates for cochlear implantation with total 66 ears were reviewed. Inner ear anomalies were identified in 8 patients representing a prevalence (24.2%) with 14 ear diseased. Anomalies were seen bilaterally in 6 patients and unilaterally in 2 patients. Among the 14 diseased ear, 9 ears (64.3%) were seen with incomplete partition Il, 7 ears (50%) were seen with enlarged vestibular aqueduct, 4 ears (28.6%) were seen with cochlear hypoplasia, 3 ears (21.4%) were seen with semicircular canal aplasia, 2 ears (14.3%) were seen with incomplete partition type I, 2 ears (14.3%) were seen with cochlear nerve aplasia, 2 ears with cochlear aplasia (14.3%), I ear (7.1%) was seen with common cavity ear (7.1%) with complete labyrinthine aplasia.

Conclusion

Prevalence of inner ear anomalies among cochlear implant candidates was 24.2%. This result is consistent with results worldwide and the most common anomalies were Incomplete partition Il and large vestibular aqueduct.

Abbreviations

Computed tomography (CT), Magnetic resonance imaging (MRI), High resolution computed tomography (HRCT), Internal auditory canal (IAC), Cerebellopontine angle (CPA).
Cross sectional study of the relationship between the presence / severity of coronary artery disease evaluated by computed tomography coronary angiography and the presence/ degree of non-alcoholic fatty liver disease evaluated by trans-abdominal ultrasonography
Authors: Hetta Waleed Mohammed , Abdeldayem Emad Hamid , Hegazi Amal Ahmed Ibrahim Ahmed
Published: October 2021

Background

Coronary artery disease is one of the common causes of mortality worldwide.

Studies have shown a prevalence of 24.5% in Egypt. Therefore, early accurate diagnosis, risk factors and associations of coronary artery disease are of utmost importance.

Objectives

The aim of the current study is to investigate the relationship between the presence / severity of coronary artery disease and presence extent of nonalcoholic fatty liver disease.

Patients and Methods

Cross-sectional study on total 52 patients performed multi-slice computed tomography coronary angiography, and liver evaluation by abdominal ultrasonography at Dar Shefaa hospital.

Results

We found that there is a positive significant relationship between the number of coronary arteries affected and the coronary lesion degree of stenosis (proven by P value= 0.909). Also, a positive significant relationship between the number of affected vessels and the degree of non-alcoholic fatty liver disease (proven by P value =-0.783). Also, a positive significance between coronary lesion stenosis degree and the degree of non-alcoholic fatty liver disease (proven by P value= 0.785).

Conclusion

The existence of non-alcoholic fatty liver disease is independently associated with the presence and existence of coronary artery disease. it is not still clear whether the non-alcoholic fatty liver disease causes coronary artery disease or whether this relationship is seem because of the common mechanisms causing both diseases, yet the relationship between the existence of hepatosteatosis and the extent of coronary artery disease has been strongly documented.
Role of Diffusion Weighted Imaging in Differentiating Benign from Pathological Vertebral Compression
Authors: Kamel Faten Mohammed Mahmoud , Rahman Hazem Ibrahim Abdel , Elkhayat Amany Sayed Khaleel Ahmed
Published: October 2021

Background

Vertebral collapse is a common problem due to benign conditions (trauma, infection, osteoporosis) or malignant process. And although the spine is the most common site of bone metastases (39% of bony metastases in patients with primary neoplasms) benign vertebral fractures due to osteopenia occur in one third of cancer patients, making it essential to determine whether the cause of vertebral collapse is benign or malignant.

Aim of the Work

To establish the role of DWI in differentiating benign from pathologic vertebral fractures using ADC values in comparison with histopathology report /laboratory evaluation and clinical follow-up.

Patients and Methods

A cross sectional study is approved by the ethics review board of Ain Shams University Hospital (Al Demerdash). All patients provided informed consent for the MR imaging examinations and for inclusion of their data in this analysis. From April 2020 to october 2020, 25 cases with previous imaging with vertebral compression underwent conventional MRI study on the affected region. Diffusion weighted imaging and ADC was added.

Results

We performed DWI using maximum b-values 600, and quantitative analysis, named apparent diffusion coefficient (ADC). We correlated the ADC number to histopathology, laboratory finding and clinical follow up. In our study there was significant difference (p < 0.04) between DWI of the benign and malignant groups. Also the ADC value showed significant difference <0.001. The mean ADCs of benign VCFs were higher significantly than those of pathological fractures.

Conclusion

DWI with ADC value was helpful when added to conventional MRI to differentiate benign from pathological (malignant) vertebral compression. It should be a routine sequence in patients with vertebral compression fractures for accurate diagnosis and successful management also can decrease no of biopsies.
Role of diffusion weighted magnetic resonance imaging in assessment of urinary bladder cancer
Authors: Al Thqaby Mahmoud Mohamed S , Abu-Gamrah Sherif H , Ibrahem Ayman M , Hussein Ahmed M , Elazab Mohamed
Published: October 2021

Purpose

The aim of this work is to ellucidate the role of diffusion-weighted imaging in T-stage of bladder cancer, to find correlation between the apparent diffusion coefficient (ADC) and histologic grade and to detect early tumor recurrence.

Materials and Methods

In this retrospective study, 34 patients were gathered, 28 men and 6 women, with ages ranging from 46 to 90 years, presented with gross hematuria or suspected of urinary bladder tumors detected on U/S and/or CT examinations. The patients were referred to Radiology department at national cancer institute for MRI examination after fulfilling inclusion and exclusion criteria. The urinary bladder tumors were classified in accordance with TNM classification from the American Joint Committee on Cancer into: T1 or lower, T2 (T2a or T2b), T3 (T3a or T3b), and T4.The mean ADC value of patients with low grade tumor (G1) and patients with high grade tumor (G2 or G3) was done The results were compared with histo-pathological examination obtained by transurethral resection (TUR) or after radical cystectomy.

Results

The overall accuracy of T stage diagnosis was 74.29% for T2-weighted images, 88.57 % for DW images, 80 % for contrast-enhanced images, and about 88.57 % for T2 plus DWIs. The mean ADC of G3 tumors was significantly lower than that of G1 and G2 tumors.

Conclusion

Our results suggest that adding DWIs to T2WIs lead to marked improvement regarding the accuracy for differentiating T2 or lower tumors from T3 and higher tumors, helping to limit the usage of contrast enhanced MRI imaging as a noninvasive diagnostic tool.
Role of MRI in Detecting and Characterizing Small Hepatic Focal Lesions
Authors: Maarouf Rania Ali , Ali Ali Haggag , Onsy Mahmoud Abdelatif
Published: October 2021

Background

Despite the recent advances in liver imaging, the detection and characterization of small hepatic focal lesions is still a real challenge. Particularly in cancer patients where the characterization of a small HFL as thus the precise tumor staging is critical for optimal treatment planning.

Aim of the Work

To explore the effectiveness, and hence the clinical utility, of MRI detection and characterization of small focal hepatic lesions either only discovered on MRI or as a further work up of CT/US-indeterminate lesions.

Patients and Methods

We reviewed our database for individuals who underwent liver MR imaging between March 2018 and March 2019 for the evaluation of small hepatic lesions that were discovered for the first time or had been previously visualized on routinely performed CT and had been considered indeterminate.

Results

The present study included 44 patients of which 26 were males (59.1%) and 18 were females (40.9%). The age range of the study group was 19 to 77 years. The mean age for Malignant lesions was 51 years. The right lobe of liver was involved in 23 cases (52.3%), left lobe in 5 cases (11.4%) and both lobes in 16 cases (36.4%). There were 30 (68.18%) benign, 13 (29.54%) malignant lesions and 1 (2.3%) indeterminate, hemangiomas were predominant in benign lesions whereas hepatocellular carcinomas were predominant in malignant lesions. N'TRI could characterize 92% cases.

Conclusion

The diagnostic process of small hepatic focal lesions, either detection or characterization or both, continues to represent a challenge. Contrast-enhanced MR can accurately detect and characterize majority of small hepatic focal lesions.
How Can an Updated 320 Multi Detector Computed Tomography Low Dose Protocol Help in Assessment of Coronary Heart Disease
Authors: Ibrahim Ahmed Samir , Abd-Eldayem Asst. Emad Hamed , Osman Mostafa Mohammed
Published: October 2021

Background

Coronary artery disease (CAD) is the single most common cause of death in the developed world, responsible for about I in every 5 deaths. The morbidity, mortality, and socioeconomic importance of this disease make timely accurate diagnosis and cost-effective management of CAD of the utmost importance. The recent years showed an overall increase in the use of CT for imaging of the heart and coronary arteries, coronary CT angiography is a rapidly growing technique that offers distinct advantages over traditional imaging techniques. However, because of rapid growth of this technique, radiation dose safety has been placed under the spotlight. Integration of dosesaving techniques will go a long way in maintaining diagnostic image quality and improving patient safety.

Objectives

The purpose of our study is the assessment of coronary artery disease by 320 MDCT and its capabilities of maintaining the quality of images and dose reduction improving patient safety.

Patients and Methods

This study was performed at New Cairo Police Hospital (Radiology department) and at Center in East Cairo, From October 2018 to October 2019, a total of 39 patients who had referred for CTCA for suspicion of coronary artery disease enrolled in our prospective study.

Results

In this study we used MDCT 64 with retrospective ECG-gating in 25.6% of patients (10 patients) and MDCT 320 with Retrospective ECG-gating was used in 25.6% (10 patients) and with Prospective ECG-gating in 48.8% (19 patients).we compared the radiation dose between prospective ECG-gating and retrospective ECG-gating acquisition techniques among all study population by the effective dose (ED) which is calculated from the DLP of the coronary scan. The effective radiation dose (ED) median was significantly lower in the prospective ECG-gating technique (7 msv) in comparison to retrospective ECG-gating technique (23 msv). We also compared the difference in radiation dose between MDCT 320 and 64 using retrospective ECG gating acquisition technique, the median (ED) was significantly lower in the 320 MI)CT technique (20 msv) in comparison to 64 MDCT (26 msv). The last comparison was the difference Of radiation dose between patients who underwent through MDCT 320 using two different techniques (prospective and retrospective), the median effective dose was lower in the prospective ECG-gating technique (7 msv) in comparison to retrospective ECG-gating technique (20 msv) this difference is also of high statistical significant value.

Conclusion

Prospective ECG-Gated CT coronary angiography protocol impressively reduces effective radiation doses in comparison to retrospective ECG-gated technique on 320 MDCT and is still sensitive for diagnosing significant coronary stenosis for patients with suspected CAD. Retrospective Coronary CT angiography can be performed with 320-MDCT with less radiation doses compared to 64-MDCT.