bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum Amyloid A in Preeclampsia
Authors: Swidan K H , Sweed M S , Abbas A M , Jewi M K
Published: May 2020

Background

Preeclampsia is a common complication of pregnancy and remains a common cause of maternal and fetal mortality. The clinical symptoms of preeclampsia are caused by widespread endothelial dysfunction suggested to be a part of an exaggerated maternal inflammatory response to pregnancy. Since preeclampsia is associated with widespread endothelial dysfunction, proposed to be provoked by an increased maternal systemic inflammatory response, the maternal plasma level of SAA might be expected to be increased when compared to normal pregnancy levels. The maternal plasma level of SAA in normal pregnancy could differ from non-pregnant level due to increased hormone levels, increased adipose tissue and\or secondary to modifications of inflammatory response in normal pregnancy.

Aims

The aim of our study is to estimate the relation between serum amyloid A in pregnant women and preeclampsia.

Methodology

the study conducted this case control study in the emergency room of Ain Shams University Maternity Hospital starting from April 2018 on women with preeclampsia to estimate serum amyloid A in pregnant women with preeclampsia. Members of the control group are healthy, non-smoker pregnant women who had an uncomplicated antenatal course and all arterial blood pressure measurements were normal.

Results

The current study was conducted in Ain Shams University Maternity Hospital in the period between January 2017 and August 2018. A total of 75 women were included in the study. The process of recruitment and handling the study population during the course of the study is shown in the flow diagram (figure 1). In order to avoid any confounding effect for a possible subclinical ongoing pathophysiological process, four women with preeclampsia lacking severe features were excluded following the development of severe features shortly after measurement of serum amyloid A level.

Conclusion

Our data sustain the limited number of studies investigating the SAA levels in both preeclamptic and healthy pregnant women, in which it was hard to reach a consensus regarding the association between SAA levels and preeclampsia. Taken in consideration that an elevated plasma level of SAA in preeclamptic women should be considered pathologic, we believe that the response of relationship between the preeclampsia and SAA levels could be caused by an inflammatory condition associated with preeclampsia. Also, serum amyloid A can be used to discriminate between mild preeclampsia cases and controls and as discriminate between severe preeclampsia cases and controls.

Recommendation

We recommended further investigation on large sample size for the elucidation of the role of SAA in pre-eclampsia neonatal outcome and the possibility of these biochemical factors to be novel markers of such disorders in pregnant women.
Study of the Vascularity of Uterine Septum Using Three Dimensional Power Doppler Ultrasound
Authors: Amer M I M , Hassan N E , Ahmed M E , Elnaggar H M M
Published: May 2020

Background

Uterine anomalies are a relatively common congenital abnormality, with uterine septum being the most common. This is even truer in patients with recurrent pregnancy loss, in whom rates of uterine abnormalities may approach 15% to 27%. Historically, the uterine septum has been approached via laparotomy through either a Tompkins or Jones procedure. These successful, but highly morbid, procedures require laparotomy with significant hospital stays, subsequent cesarean delivery, and have carried a high risk of adhesion formation. More recently, this surgery has been supplanted by hysteroscopy or other minimally invasive methodologies.

Objective

To assess the relation between the vascularity of uterine septum and obstetric performance with Transvaginal 3D Power Doppler Ultrasound.

Patients and Methods

Early Cancer Detection Unit and Ultrasound and Fetal special care Unit in Ain Shams University Maternity Hospital (ASUMH). Recruitment took place between May 2017 and November 2018. Cross-sectional study. The study included 30 cases of women with uterine septum. Intervention: Transvaginal 3D power Doppler ultrasound was done to all cases with septal volume and vascularity assessment using VOCAL system and Histogram facility. The study included 30 patients with septate uterus, twelve of them suffered from 1ry infertility while the other eighteen suffered from recurrent abortion.

Results

There was statistical significant difference between the two groups regarding vascularity (VI, FI, and VFI) of septum (P < 0.05).

Conclusion

The vascularity of septate uterus is variable. The power Doppler indices shows that septate uterus in cases with recurrent abortion is highly vascular while in cases with 1ry infertility shows low vascularity. Highly vascular septum may be a site of implantation which may be a cause of recurrent abortion thus; excision of the septum may help prevent recurrent abortion, while low vascular septum may prevent implantation which may be a cause of infertility thus; incision of the septum may help in treatment of infertility. Correlation with histopathologic features of septum may be required to decide the best management of the septum.
Transverse Versus Longitudinal Uterine Incision in Abdominal Myomectomy: A Randomized Controlled trial
Authors: Elguindy A , Hemeda H , Esmat M , Nawara M , Metwally A M F
Published: May 2020

Objective

The Aim of the study is to compare between transverse and longitudinal uterine incision in abdominal myomectomy regarding intraoperative blood loss Design: A randomized Controlled interventional study.

Setting

Ain Shams Maternity teaching hospital.

Patients and methods

52 patients undergoing abdominal myomectomy for single myoma were involved The patients were randomized into two groups that showed no significant difference in demographic data, characters of myoma or indication of surgery

Results

Our results proved that there was no significant difference between both incisions regarding intra-operative blood loss, need for blood transfusion, post-operative Hgb drop, operative time or incidence of postoperative fever.

Conclusion

Transverse uterine incision for myomectomy does not cause more blood loss than longitudinal incision. There is no difference between both incisions in operative time or postoperative complications Trial identifier: NCT03009812, MY-789
In Depth Analysis of Maternal Mortality in Ain Shams University Maternity Hospital in 2014-2017
Authors: Elqady O S , Riad A A M , Abdellah I E S
Published: May 2020

Background

Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. To facilitate the identification of maternal deaths in circumstances in which cause of death attribution is inadequate, a new category has been introduced: Pregnancy-related death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death.

Aim of the Work

is to determine outline and asses the magnitude and the factors contributing to maternal mortality, especially the avoidable factors and to evaluate the possibility of prevention of such factors, to decrease the incidence of maternal mortality to the least possible value, and finally to make some recommendations and comments for possible preventive measures.

Patients and Methods

This retrospective study was be done to detect accurate prevalence and most common causes of maternal deaths in Ain Shams maternity hospital over the last four years from 1 January 2014 to end of December 2017. Ain Shams Maternity hospital is one of Ain Shams University teaching hospitals located at Abbaseya district serving large population area, producing its governmental medical services by low fees and nominal prices.

Results

The substandard care cases were only (21) cases from total of (161) mortality cases representing (13.043%) from total mortalities, so MMR was (0.4937) per 1000 live births. This was the real MMR that the hospital and health system might had the ability to prevent their occurance.

Conclusion

For improving maternal heath, four essential elements should be done: adequate primary health care at all levels, and an adequate share of the available food for girls from infancy to adolescence, and family planning universally available, to avoid unwanted or high risk pregnancies. After pregnancy begins, good prenatal care, including nutrition with efficient and early detection and referral of high risk patient. The assistance of a trained person for all women in child birth, at home or in the hospital. Women at higher risk must all have effective access to the essential elements of obstetric care.
Vaginal versus Intramuscular Progesterone for Prevention of Preterm Labour in Women with a Twin Pregnancy: a Randomized Controlled Trial
Authors: Tantawy W H , Ghaleb M M , Elsayed M M A
Published: May 2020

Background

Twins constitute 2-4% of all births, and the rate of twining has increased by 76% between 1980 and 2009.Twin pregnancies, compared with singletons, are at increased risk for fetal anomalies, preterm births, aberrant fetal growth, cerebral palsy, and perinatal and infant mortality. Maternal complications associated with twin pregnancies include hypertensive disorders, gestational diabetes, cesarean delivery, postpartum hemorrhage, and maternal mortality.

Aim of the Work

This study aims to assess the efficacy of vaginal progesterone compared to intramuscular therapy in decreasing the rate of preterm birth in women with twin pregnancy.

Patients and Methods

Randomized Controlled Trial, women presented to Ain Shams University Maternity Hospital. The study was presented for approval from the ethical committee of the department of Obstetrics and Gynecology, faculty of medicine, Ain Shams University. Informed consent after explaining the study purpose and methods to the subjects. Data presentation will not be by the patient name but by diagnosis.

Results

There is no statistically significance between the two groups regarding number of neonatal RDS, NICU admission and neonatal death but lower percentage among vaginal progesterone group. Birth weight was significantly higher among vaginal group. NICU stay was significantly higher among intramuscular group.

Conclusion

Compared with intramuscular 17-OHPC, vaginal progesterone in women with twin pregnancy is associated with lower percentage of preterm labour, less recurrent SPTB, less adverse maternal side effects, fewer NICU admissions, better compliance.
Endometrial Thickness and Subendometrial Vascularity in Anovulatory Polycystic Ovarian Syndrome Patients Treated by Metformin
Authors: Khalaf W M , Akl S A , Ramadan R R , Kamaleldin M A M
Published: May 2020

Background

PCOS, the commonest endocrinalogical disorder affecting women of age group between 18 and 44 years. PCOS compromises fertility through various pathways as hyperandrogenism, insulin resistance and impedance of the uterine and endometrial blood flow. Metformin improves the blood flow to the endometrium through reducing androgen level and correction of insulin resistance. The commonest parameters used to detect the endometrial receptivity outcome are endometrial vascular indices.

Aim of the Work

to evaluate the outcome of metformin administration in anovualtory PCO patients and its effect on the endometrium, including its role in ovulation and improvement of pregnancy rates.

Patients and Methods

this study included 85 patients from Ain Shams University outpatient gynecology and infertility clinic during the period from January 2018 till June 2018. These patients were investigated before treatment with ultrasound on day 14, 21 to evaluate the endometrial receptivity parameters such as endometrial thickness, uterine artery vascularity, endometrial and subendometrial vascularity. The patients received metformin 500mg three times per day for three months. After this duration they were reevaluated by ultrasound at days 14, 21 to detect any improvement.

Results

metformin therapy resulted in a significant increase of endometrial thickness and had a significant effect on uterine RI and PI. On the endometrial level, the endometrial and subendometrial R.I and P.I were significantly reduced after metformin treatment indicating better blood flow.

Conclusion

Metformin therapy improves endometrial vascularity, in addition to increasing endometrial thickness and improved impedance observed in uterine artery flow.
Concurrent Palliative Chemoradiotherapy versus Definitive Chemoradiotherapy in Poor Prognosis Stage III non-small-cell lung cancer
Authors: Elkhafif M A , Elbassiouny M , Elhusseny K , Salem D , Shafik A
Published: May 2020

Background

The palliative role of chemoradiation in treatment of patients with locally advanced non-small-cell lung cancer remains unresolved; Controversy remains about whether long term and high doses radiotherapy provide better results than short course schedules in treatment of inoperable stage III NSCLC and negative prognostic factors poor performance status (PS), large tumor, poor pulmonary functions and comorbidities.Hypofractionated radiotherapy can expose tumors to a high dose of radiation in a short period of time.

Methods

One hundred and ten patients with locally advanced stage III NSCLC with poor prognosyic factors were randomized to receive either definitive chemoradiation or palliative chemoradiation in cancer department of faculty of medicine of AIN SHAMS UNIVERSITY .Arm (A) patients will receive induction chemotherapy with two cycles of carboplatin(AUC6) and paclitaxel 175mg/m²) cycles every 21 day, the third cycle administrated with radiotherapy with low dose of carboplatin(AUC 2) and paclitaxel 60 mg/m² on day 1& 8 administrated concomitant with the radiotherapy 42 Gy over 15 fraction over 3 weeks. Arm (B) patients will receive standard-dose fractionation of radiation 60Gy/6 weeks 2Gy once per day with concurrent weekly low dose of carboplatin (AUC 2) and paclitaxel 60 mg/m² followed by two cycles of full doses of carboplatin (AUC 6) /paclitaxel 175mg/ m² every 21 days.the primary end points were overall survival and progression free survival;secondary end points were health related quality of life(HRQOL) and toxicity.

Results

The median follow-up duration was 24 months in surviving patients’ .Median survival and 2-year OS were in concurrent palliative chemoradiation arm 4.7 and 12.3-months respectively and was 7.3 and 17.6 in concurrent definitive chemoradiatiobn arm respectively (p < 0.01). HRQOL was better in the palliative arm during the treatment but remained unchanged in both arms during the follow up visits. There were more hospital admissions related to side effects in the definitive chemoradiation arm (p < 0.05).

Conclusions

This study confirmed that the definitive chemoradiation was superior to palliative chemoradiation arm with respect to survival.the treatment related toxicity and HRQOL were better in the palliative chemoradiation arm than the definitive arm.
Retrospective Analysis of Clinical Epidemiology in Gastrointestinal Stromal Tumour
Authors: Farag A L , Ezzeldin M M A , Mosalam N A , Mohammed M M A A
Published: May 2020

Background

Gastrointestinal Stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract (GIT) i.e. sarcoma. GIST is classified into mutation in KIT (cluster of differentiation 117, CD117) oncogene (85%), Platelet — derived growth factor receptor alpha gene (PDGFRA) (10%) or rarely B-Raf gene. C.Kit - which is mutated & activated in 80% of GIST- is an oncogene which encodes cell surface receptor Tyrosine Kinase TK (CD 117) which is responsible for activation of multiple signaling cascades leading to cellular proliferation.

Aim of the Work

to explore the best management options of care for patients at Ain Shams University Hospitals (ASUH) by retrospectively analyzing epidemiological factors in Gastrointestinal stromal tumor patients and correlate them to clinical outcome; these factors are either patient or disease ones, while outcome include clinical benefits, survival and encountered toxicities.

Patients and Methods

this is a retrospective study. This study included 34 patients with GIST treated at the department of Clinical Oncology and Nuclear medicine, Ain Shams University between 2011 -2017 and followed up till 1-2017.

Results

many prognostic factors were selected for analysis to evaluate their impact on overall survival. Age, gender, site and size of tumor, mitotic index, histopathology, presence of metastasis at time of presentation and anemia all had no statistically significant impact on overall survival.

Conclusion

the prognosis of GIST is undoubtedly better than other sarcomas. No clear risk factor of GIST. Patient selection is paramount as to minimize the high cost of treatment. Tumor density must be known by Hounsfield unit before treatment to detect pseudo progression. Molecular analysis by PCR is very important to know sensitivity to treatment as a predictive biomarker. Patients should be kept on follow up for early detection of recurrence.
A retrospective study of Epidemiology and prognostic factors of small cell lung cancer
Authors: Elwakeel H , Ellithy M , Hassanien S , Helaly M
Published: May 2020

Background

Lung cancer has been the most common cancer overall for several decades. According to the last data of GLOBOCAN series of the International Agency for Research on Cancer there were estimated 1.8 million new cases in 2012 of which 1.2 million cases estimated to occur in males with lower incidence rate in females about 583,000 cases.

Aim of the work

This study aims to ascertain retrospectively the epidemiology and prognostic factors of small cell lung cancer (SCLC) and also highlights the outcomes in the terms of overall survival (OS) and progression free survival (PFS) among Egyptian patients at clinical oncology and nuclear medicine department, Ain Shams university hospitals

Results The files of 56 patients with SCLC were reviewed. 17 patients were excluded from analysis due to insufficient data in the files. Among the 39 patients in the study, 32 patients received active treatment, while 2 patients received only WCI as palliative intent, 2 patients received best supportive care treatment as they were not fit for treatment (PS: 3-4) and 3 patients didn’t receive treatment as they lost follow up before starting treatment.

Conclusion

SCLC is usually diagnosed in advanced stage and No great improvement in survival over the past years, so, health care centres should monitor the efficacy of their management plans by comparing survival outcomes with other centres. Prognostic factors are essential in better understanding the treatment outcome in terms of OS and PFS.
Retrospective Analysis of Clinicopathologic and Management Aspects of Soft Tissue Sarcoma
Authors: Kamel T H , Adel A M , Faheim R M , Hegazy R
Published: May 2020

Background

Soft tissue sarcomas (STS) are a group of rare aggressive tumors of mesenchymal origin, separated into over 50 different subtypes by histological and molecular classifications, In this analysis we evaluated the clinicopathologic and management aspects of STS. We analyzed the prognostic and predictive factors affecting both OS & PFS.

Patients and Methods

Medical records of 92 patients with STS were reviewed retrospectively. Overall survival (OS) and progression free survival (PFS) were estimated and factors potentially influencing these outcomes were analyzed.

Results

The mean age of patients was 45 +- 15.95 years (range 16-84 years). Median OS was 35.6 +_ 5.2 months and median PFS was 10.2 months. Age was assessed as a predictive factor for OS and patients <50 years had higher median OS (42.3 months) compared to patients >50 years’ old who had median OS (13.2 months) with no statically significance (P = 0.069). Also patients ≤50 years had median PFS (12.1 months’ vs 10.1 months) in patients ≥ 50 years with no statistically significance on PFS type. Type of pathology was also highly significantly correlated to overall survival (P = 0.000), liposarcoma had improved OS (42.3 months) compared to other histopathological subtypes. However, it showed no statistically significance to PFS (P = 0.036) with higher median PFS in liposarcoma (22.3 months) compared to other histopathological subtypes.

Conclusion

Mean age was found to be 45.9 +- 15 years old, with type of pathology. Histopathological subtypes and disease status were assessed as predictive and prognostic factor and were found to be highly correlated to OS. Effect of RTH on OS and PFS is well noted
Evaluation of retinal vasculitis among cases of Behçet disease
Authors: Samaan M E B , Saad A H , Mohammed T H , Elzankalony Y A
Published: May 2020

Background

Behçet disease is an obliterative and necrotizing systemic vasculitis that involves different organ systems. It affects both arteries and veins, mainly the veins. Ocular affection is one of the major criteria of Behçet disease; the most common ocular presentation is bilateral non-granulomatous panuveitis with retinal vasculitis.

Purpose

To identify early, evaluate and follow-up properly the posterior segment involvement in Behçet disease cases with the help of Fundus fluorescein angiography and Optical coherence tomography.

Patients and Methods

This is a descriptive cross sectional study involved 40 eyes. All patients had a complete ophthalmological examination, a comprehensive history taking as well as review of systems and the laboratory tests. This is followed by pupillary dilatation and retinal imaging by fundus fluorescein angiography and optical coherence tomography.

Results

On ophthalmological examination, 35 eyes had retinal affection due to Behçet disease and 5 eyes are retina-free. The most common retinal affection was vasculitis in 29 eyes, followed by optic nerve affection in 10 eyes then less common was retinitis in 6 eyes. Regarding visual acuity (VA) 14 eyes had low visual acuity of less than (6/60), 21 eyes had VA between (6/60 – 6/12) and 5 eyes had good visual acuity of more than (6/12). Fluorescein angiograms showed that, 36 eyes representing 90% of the total eyes had abnormal angiogram; vascular leakage was the commonest abnormality in 29 eyes, less common was optic disc edema in 12 eyes, then retinitis in 6 eyes. Macular edema was present in the angiogram of 6 eyes. About OCT, there were abnormalities in 33 eyes; macular edema was the most common in 21 eyes, epiretinal membrane (ERM) in 9 eyes, then neurosensory detachment (NSD) and macular hole each was seen in 4 eyes.

Conclusion

This study demonstrated that posterior pole involvement, retinal vascular leakage, optic disc hyperfluorescence, and macular leakage are significantly associated with worse VA in Behçet retinal vasculitis. This suggests that, use of Fundus Fluorescein Angiography and Optical Coherence Tomography in evaluation of Behçet retinal vasculitis is clinically significant in predicting visual prognosis and determining of treatment efficacy.
Subfoveal Choroidal Thickness Measured By Swept Source OCT in Retinitis Pigmentosa Patients
Authors: Mahmoud Y M , Eliwa T F , Elmofty H M , Elmaamoun T A
Published: May 2020

Background

Retinitis pigmentosa (RP) encompasses a group of hereditary retinal diseases that result in progressive loss of rod and cone photoreceptors. It occurs in approximately one in 4000 individuals, with a worldwide prevalence of 1.5 million affected individuals.

Aim of the Work

This study aimed measure the subfoveal choroidal thickness and outer retinal layer thickness in patients with Retinitis Pigmentosa and correlate them with visual acuity.

Methods

Fifty eyes of clinically and electrophysiologically confirmed retinitis pigmentosa patients compare to fifty eyes of normal healthy individuals of the same age group as controls.

Both groups were investigated for best corrected visual acuity (BCVA)(LogMAR) and Swept Source optical coherence tomography (SS-OCT) evaluating outer retinal layer thickness (ORL), central foveal thickness and subfoveal thickness (SFCT) and the integrity of inner segment-outer segment junction IS/OS as being (Intact (+) or disrupted (-)),

Results

Mean ages were 34.5 ± 11.3 years for controls versus 38.8 ±12.8 years for RP patients (p > 0.05). Mean BCVA (logMAR) was 0.86 for RP group vesus 0.02 for control group. Mean subfoveal choroidal thickness (SFCT) measurements were significantly lower in RP group (288.4 µm) than control group (333.7µm) (P value = 0.008). Significant difference was found between choroidal thickness and BCVA (logMAR) (p-value <0.001). Presence of IS/OS was significantly correlated with BCVA (log MAR) (p value=0.0001). And finally, there was moderate negative correlation between central foveal thickness and BCVA (logMAR) (r = -0.414, p-value = 0.012).

Conclusion

Submacular choroidal thickness as measured by SS–OCT, is significantly reduced in patients with RP and significantly correlated to BCVA and IS/OS integrity.
Effect of Ranibizumab Treatment in Cases of Choroidal Neovascular Membranes Secondary to Pathological Myopia versus Age-Related Macular Degeneration
Authors: Abdaltawab M S , Ismail Z F , Ebeid W M A , Fawzy S M
Published: May 2020

Aim of the Work

The aim of this work is to compare the response of treatment with ranibizumab in terms of visual acuity in cases of CNV secondary to pathological myopia versus CNV secondary to age-related macular degeneration.

Methods

This prospective, comparative study included ten eyes newly diagnosed as having CNV secondary to pathological myopia, and 10 eyes newly diagnosed as having subfoveal active CNV secondary to AMD. All patients had 3 monthly intravitreal Injections of 0.50 mg (in 0.05 ml of solution) ranibizumab with monthly evaluation of best corrected visual acuity (BCVA) by Landolt C chart, and also calculated in Logarithm of Minimum Angle of Resolution (Log MAR).

Results

pretreatment there was no significant difference between the two groups as the mean VA (Log Mar) was 1.31 ± 0.2 in AMD group and 1.17 ± 0.3 in MCNV group of P value = 0.431 and also post three IVI of ranibizumab showed no significant difference between the two groups as the mean VA (Log Mar) was 1.22 ± 0.2 for AMD and 1.22 ± 0.5 for MCNV of P value = 0.635.

Conclusion

there was no significant difference in BCVA between AMD and MCNV groups after three intravitreal injections of ranibizumab.
Comparison between the Characteristics of Femtosecond laser Anterior Capsulotomy Versus Manual Capsulorhexis and their Effects on Intra Ocular Lens Centration, Effectiveness and Safety in Cataract Surgery
Authors: Ali D A M , Hamza I I , Abdelrahman S H , Abdelaziz T M
Published: May 2020

Background

Cataract is characterized with opacity of the crystalline lens that can markedly limit the routine activities of patients such as reading, writing, walking and in the long run reduce the quality of life. Cataract is the main cause of preventable blindness. Despite some modern advances in the field of cataract impending drug treatments, surgical treatment is still known to be the most actual treatment option(1).

Objective

To perform a meta-analysis on the characteristics of femtosecond laser anterior capsulotomy and manual capsulorhexis and their effects on intra ocular lens (IOL) centration, effectiveness and safety in cataract surgery.

Methods

This meta-analysis was conducted from 1/1/2015 to 31/7/2018. Literature search on PubMed was done to identify randomised controlled trials (RCT) and comparative studies MedCalc ver. 18.2 (MedCalc, Ostend, Belgium) was used for data analysis.

Results

Of the 17 articles included, there were 3 (18%) randomised controlled trials and 14 (82%) comparative study. The meta-analysis was based on a total of 18558 eyes. Of them, 9442 (50.88%) underwent femtosecond laser-assisted cataract surgery (FLACS) and 9116 (49.12%) underwent manual continuous curvilinear capsulorrhexis (CCC). Comparative study between the 2 groups revealed; highly significant increase in better IOL centration; in FLACS group compared to CCC group (p < 0.01), there is non-significant difference as regards capsulotomy diameter (p > 0.05) and non-significant difference as regards corrected distant visual acuity (CDVA) ,un corrected distant visual acuity (UDVA) and mean absolute error (MAE) (p > 0.05).

As regards the complications; fixed-effect model showed highly significant increase in complications rate in FLACS group; but random-effects model showed non-significant difference between the 2 groups (p < 0.001, p > 0.05 respectively).

Conclusion

FLACS is better for IOL centration, but there is non-significant difference between FLACS and manual CCC as regards capsulotomy diameter, CDVA, UDVA, MAE and complication rate.
Correlation of Structural and Functional Changes in Ocular Hypertension and Early Glaucoma
Authors: Noureldin W O , Ebiary H M , Zaki R G
Published: May 2020

Purpose

To estimate the link between the thickness of retinal nerve fiber layer (RNFL); utilizing optical coherence tomography (OCT) and corresponding retinal sensitivity changes; utilizing visual field (VF) perimetry, in cases of ocular hypertension and early glaucoma.

Methods

Thirty patients (60 eyes) were gathered for this prospective, cross-sectional study. They were categorized into two groups. Group I comprised 30 eyes (15 patients) having ocular hypertension. Group II comprised 30 eyes (15 patients) early recognized as primary open angle glaucoma. Each patient underwent a thorough ophthalmologic examination, OCT for RNFL thickness estimation using quick RNFL thickness protocol and VF testing using automated perimetry (G2 program, central 30–2 threshold protocol). Pearson’s correlation was premediated between thickness of RNFL and VF indices.

Results

Significant connections between the thickness of temporal area of RNFL and mean sensitivity (MS), mean defect (MD) and loss of variance (LV) indices of VF (r = 0.533, -0.431, -0.388; P < 0.01, respectively) were noticed in patients having ocular hypertension. Additionally, a significant link between the thickness of the temporal area of RNFL and MS index of VF (0.441; P < 0.05) was noticed in patients with early POAG. Otherwise, there were no significant links between indices of VF and other areas of RNFL thickness in both groups.

Conclusion

Average RNFL thickness is certifiably not a dependable index for early determination of glaucoma or for the follow-up of ocular hypertension and POAG. Segmental RNFL thickness (especially temporal) appears to be a more dependable index. Profound structural modification with OCT test comprises an imperative sign of early utilitarian changes, regardless of whether they are not yet recognized with perimetry. The MS index of VF is by all accounts sensitive for the follow-up of ocular hypertension.
Assessment Of Choroidal And Retinal Changes In Cases Of Central Serous Chorioretinopathy Treated With Oral Eplerenone
Authors: Abdelaziz N A , Abdalla T M , Thabet Y A , Fawzy S M
Published: May 2020

Aim of the Work

This prospective analysis was planned for patients with chronic central serous retinopathy (CSR) more than three months who receive oral Eplerenone for treatment. It is aimed to reduce &resolve sub retinal fluid with improving anatomical and physiological visual functions.

Patient &Methods

sixteen eyes with untreated chronic Central Serous Chorioretinopathy patients who recruited from the ophthalmic clinic. Main intervention is medication by standard dose of Eplerenone, 50mg once daily. Investigated by Optical Coherence Topography at base line, one month after treatment and three months later. Over the course of the study, patients were monitored for side effects, visual and anatomical response to the medication.

Results

Significant difference in BCVA is found that was 0.675 ±0.2696 at base line to 0.48125±0.2287 after one month after treatment and to 0.04375±0.07274 three months after treatment, (p = 0.000). Sub retinal fluid measurements were improved significantly between each two visits as horizontal fluid volume is improved from 2137 ±987.93 at base line to1559.875 ±677.60 after one month after treatment and to 0 three months after treatment. Vertical fluid volume is improved from 203.125 ±118.73 at base line to122±49.876 after one month after treatment and to 0 three months after treatment. Central sub field thickness were improved significantly between each two visits as it is improved from 372.375 ±92.994 at base line to331.8125 ±90.283 after one month after treatment and to 250.25±25.970 three months after treatment. Contrast sensitivity improved significantly between each two visits as it is improved from 8.7625 ±4.029 at base line to 5.1968±3.227after one month after treatment and to 1.4968±0.4750 three months after treatment. Choroidal thickness was improved significantly between each two visits as it was improved from 267.9375 ±67.451 at base line to222±52.262 after one month after treatment and to 174.0625±23.713 three months after treatment. 100% of the patients complained from positive scotoma at base line, Improved to 44% of the patients complained from positive scotoma one month after treatment, improved to 0% three months after treatment.

Conclusion

Eplerenone therapy resulted in significant anatomic and visual improvements in eyes with chronic central serous Chorioretinopathy.
Survey of Interpupillary Distance in Egyptian People
Authors: Elrazky M K , Abdallah T M , Roshdy M M , Farweez Y A T
Published: May 2020

Purpose

The aim of this study was to report normative values and ranges of interpupillary distance (IPD) in Egyptian people.

Methods

This study included 83 healthy subjects; 41 males and 42 females presented with refractive errors to the outpatient clinic of Elshiekh-Zaid specialized hospital in Cairo. After complete ophthalmic evaluation, far IPD measurements were performed using an autorefractometer (Speedy-1, Nikon, Japan), graded ruler (401 A5 stainless hardened, Japan), spectacle frame with two cross-wire lenses (universal trial frame, Carejoy, China). Near IPD measurements were performed using the graded ruler and the spectacle frame.

Results

Mean age of the study population was 35.1±8.0 years (range 20-50). The mean IPD for far was found to be 64.1±3.7 mm (range 56-72) by autorefractometer (p < 0.001), 63.9±3.7 mm (range 56-72) by PD ruler (p < 0.001), and 62.9±3.7 mm (range 55-71) by frame (p < 0.001). The mean IPD for near was found to be 61.9±3.7 mm (range 54-70) by PD ruler (p < 0.001), and 61.0±3.6 mm (range 53-68) by frame (p < 0.001). The mean IPD value was observed to be significantly higher among males (p < 0.001). Far and near IPD difference by PD ruler was 2.0±0.5 mm (p < 0.001) and by frame was 1.9±0.6 mm (p < 0.001).

Conclusion

The current study showed normative data on far IPD and near IPD by different methods in Egyptian people. Our study showed that sex and age had significant effects on IPD. Knowledge of normal values in this population may be useful in studying orbito-cranial growth patterns, syndrome diagnosis, surgical management of cranio-facial deformities and trauma, and manufactures of optical frames and lenses.
Prevalence of Glaucoma among High Myopia
Authors: Abdelfatah O M , Salem O A , Elawamry A I , Elzanklony Y A
Published: May 2020

Background

Glaucoma is an optic neuropathy that is characterized by the selective loss of retinal ganglion cells and their axons, which manifests as the loss of the retinal nerve fiber layer (RNFL). Numerous studies have shown that the extent of RNFL damage correlates with the severity of functional deficit in the visual field (VF), and that RNFL measurement by optical coherence tomography (OCT) has good sensitivity for the detection of glaucoma.

Purpose

To assess the prevalence of glaucoma among high myopic patients and the association between them using standard automated perimetry (SAP) and optical coherence tomography (OCT).

Patients and Methods

A prospective observational randomized cross sectional study included a total of 80 eyes with high myopia, in the period from November 2017 to April 2018. This cross sectional study included 44 subjects with 80 eyes regarding high myopia using the outpatient services of the Qlawoon Hospital, Cairo, who satisfied the inclusion and exclusion criteria between November 2017 and April 2018 aiming to determine the prevalence of glaucoma in high myopic patients.

Results

In our study, we depended on the following highly significant parameters in detection of prevalence of glaucoma among high myopic patients: Spherical equivalent median is -12, Vertical cup/disc ratio mean is 0.55, MD median of visual field is – 5.38, PSD mean of visual field is 3.53, GHT is 64.7% outside normal limits, 17.6% border line and 17.6% general reduction of sensitivity and RNFL thickness mean is; for average thickness is 86.37, for superior thickness is 90.06 and for inferior thickness is 82.68 a highly significant P-value.

Conclusion

Prevalence of glaucoma among our study group is 42.5% depending on Spherical equivalent median, Vertical cup/disc ratio mean, MD median of visual field, PSD mean of visual field, GHT and RNFL thickness.
Management of Metastatic Bone Disease of the Extremities: A Systemic Review
Authors: Mostafa M A , Azmy S I , Ahmad M A
Published: May 2020

Metastatic tumors are the commonest Tumors of the bone. Wide variety of surgical modalities are available for management of bone metastasis. This review describes functional improvement, pain control, and survival after surgical management of the bone metastasis. Surgical management is found to lead to better pain control and functional improvement, with comparable results of survival rate with other reviews like ours.
Results of Modified Ilioinguinal Approach in Management of Acetabular and Pelvic Fractures (A Systematic Review and meta-analysis of Literature)
Authors: Fahmy H A , Sallam A M , Abdelsamad M M A
Published: May 2020

Background

Modified ilioinguinal approach was introduced to manage anterior acetabular fractures to reduce the morbidity & complications of the classic ilioinguinal approach, a less invasive anterior approach consisting of a medial window combined with the lateral window of the ilioinguinal approach.

Aim of the Work

a systematic review to determine whether the modified ilioinguinal approach is better the classic ilioinguinal approach in managing traumatic acetabular fractures by comparing the results in each study.

Materials and Methods

5 studies(from 2010-2017) were included & reviewed the results of 147 patients operated by modified ilioinguinal approach in terms of: operative details, intraoperative & postoperative complications, postoperative reduction quality & final clinical outcome assessment, & results was analyzed & pooled together to reach a satisfactory outcome.

Results

Modified ilioinguinal approach showed operative time (123.2±6.83 minute), relatively small amount of blood loss (200-1000 ml) & better quality of reduction (84.8% had anatomical reduction, 10.9% had fair reduction, and 4.3% had poor reduction). However there were no significant differences in terms of postoperative complications & final clinical outcome assessment between different studies.

Conclusion

It was concluded that the modified ilioinguinal approach allowed reduction of anterior column and pelvic ring fractures without requiring dissection through the inguinal neurovascular structures. Results showed that its possible with this approach to reach safe reduction and stable fixation.
Treatment of Open Tibial Fracture by Ilizarov External Fixator versus Unreamed Interlocking Nail
Authors: Fayed M M H , Alkersh M A , Eldesouky A E
Published: May 2020

The objective of this study is to compare the radiographic results and clinical outcome of unreamed tibial nailing (UTN) and Ilizarov external fixation (IEF) for the treatment of open fractures of the tibia. Patients with open tibial shaft fractures were treated with an IEF or UTN. Both groups were compared for union time, nonunion, infections, mechanical failure of the implant, and malunion. We searched numerous sources and eventually included studies, totaling participants.
The Outcomes Of Autologous Platelet Gel In Bone Reconstruction Of Defects In Patient With Benign Bony Cystic Lesions
Authors: Mostafa M A , Kamel A S , Kheir S I A , Abdelaal M M
Published: May 2020

Background

Although autologous bone grafting is still considered the ‘‘gold standard’’ in bony defect repair, the past century has seen significant advances in the development of valid alternatives to natural bone.

Aim of the Work

The purpose of the present study is to assess short term clinical and radiographic outcome of bone defect reconstruction by platelet gel mixed with hydroxy appetite/beta tri-calcium phosphate ( HA/B-TCP) bone substitutes after extended curettage.

Patients and Methods

we conducted a prospective study involving 20 patients underwent extended curettage and reconstructed by platelet gel mixed with HA/B-TCP bone substitutes. The mean follow up period was 18 months and MSTS score was used to evaluate the patients clinically and NEER classification system for radiological assessment.

Results

twelve patients of twenty showed excellent healing with NEER I , Six patients were classified as NEER II and Two patients showed recurrence and the mean MSTS score was 90.8-+9.9 .

Conclusion

reconstruction of the bone defect by bone substitute with platelet gel is a good option for avoidance the morbidity of the bone grafts.
Treatment of Blount’s Disease by Temporary Hemiepiphysiodesis Using Eight Plate (A Systematic Review)
Authors: Yousry A H , Elbeshry S S , Abdullah M H A
Published: May 2020

Background

Tibia vara (Blount’s disease) is an orthopedic condition that affects young children causing varus deformity of the knee. Blount described tibia vara as “an osteochondrosis located at the medial side of the proximal tibial epiphysis.” Currently, tibia vara is considered an acquired disease of the proximal tibial metaphysis, However, rather than an epiphyseal dysplasia or osteochondrosis. The exact cause is unknown, but enchondral ossification seems to be altered. Suggested causative factors include infection, trauma, osteonecrosis and a latent form of rickets, although none of these has been proved. Combination of hereditary and developmental factors is the most likely cause. Weight bearing must be necessary for its development because it does not occur in non-ambulatory patients and the relationship of early walking and obesity to Blount disease has been clearly documented.

Purpose

to establish, through the literatures, what is the effectiveness of temporary hemiepiphysiodesis by eight plate in treating Blount’s disease.

Methodology

A systematic review was carried out on several studies which met the inclusion criteria. In this Study we conducted an up-to-date review of the studies discussing results of use of eight plates in temporary hemiepiphysiodesis in Blount disease and published between June 2008 and June 2018.

Results

in our study, success rate is 67.1% with a considerable rate of correction of mechanical axis deviation ranging between 0.58 mm\month to 1.5mm\month. Success rate in infantile age group was 95%, while in adolescent age group was 48%.

Conclusion

it is evident that results of 8-plate in Blount disease is much better in infantile group of age than adolescent group. So, 8-plate can be used in treatment of Blount’s disease up to stage IV. The results are better in low BMI and younger age group .
Comparative Study between Nancy Nail and Conservative Treatment in Diaphyseal Fracture Tibia in Children
Authors: Fayyad T A , Aly A S , Abdulfatah A G
Published: May 2020

Background

nonphyseal fractures of the tibia and fibula are among the most common injuries involving the lower extremities in children and adolescents; represent approximately 15% of all pediatric fractures. They occur more frequently in boys than girls.

Aim of the Work

assessing of efficacy and safety of treatment of diaphyseal fracture tibia in children by nancy nail versus conservative treatment.

Patients and Methods

this review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines.

Results

ESIN is an ideal device for treating pediatric tibial fractures allowing mobilization and maintenance of alignment until bridging callus forms. The device would exploit the rapid healing and ability to remodel without risking the physis or blood supply to the tibia.

Conclusion

the present study supports the treatment of tibial shaft fractures in children aged 8-13 years with ESIN, as it hastens fracture union, and allows earlier, weight bearing, rehabilitation and return to normal activity.
Mesenchymal stem cells reduce both inflammation and mortality in chronic cerebral murine toxoplasmosis
Authors: Elhosseiny L M , Badawy A F , Elashkar A M , Abuzahra F A , Abdelsamee N M , Brakat A M A , Elgohary S A
Published: May 2020

Bone marrow-derived mesenchymal stem cells (BM-MSCs) are self-renewing, clonal precursors of non-haematopoietic tissues, with anti-inflammatory and anti-apoptotic effect. This study aimed to evaluate the effect of BM-MSCs on chronic toxoplasmosis. BM-MSCs were isolated from 6-wk-old BALB/c donor male mice, then grown and propagated in culture until cell count was 5–8x106/ml. Female Swiss albino mice were divided into five groups: Group I (infected mice injected with BM-MSCs); Group II (infected mice treated with both BM-MSCs and conventional treatment); Group III (infected mice conventionally treated with Spiramycin-Metronidazole combination); Group IV (infection control group in which mice were infected with Me49 strain of Toxoplasma gondii) and Group V (non-infected mice injected with BM-MSCs). Histopathological examination of brain tissue and survival rate were assessed in each group. Compared to the infection control group and conventionally treated group, the infected mice injected with BM-MSCs showed less tissue damage, mild inflammatory changes in brain sections and low mortality rate. The group treated with both MSCs and conventional treatment showed unexpected sever inflammation and the highest mortality rate.
Genotyping of Parasites: Implications on Clinical Manifestations and Epidemiology
Authors: Khalifa K E
Published: May 2020

Genotyping is the technology that detects small genetic differences at the level of specific alleles by comparing a DNA sequence to that of another sample or a reference sequence. Genetic variations at a specific allele may lead to change in phenotype of the organisms that determine virulence, drug resistance, immune response, clinical manifestations and transmission. The aim of the talk is to present the basics of genotyping technology and the implications of parasite genotype on clinical manifestations and epidemiology with reference to Toxoplasma gondii.
Crosstalks between helminthes and microbiota to improve gut health
Authors: Elwakil H S
Published: May 2020

Intestinal helminths are potent regulators of their host’s immune system and can protect against Inflammatory bowel disease. This anti-inflammatory activity remains largely unknown. Is it purely intrinsic to helminths, or whether it also involved cross interaction with the local microbiota? Microbiota and helminths have coevolved within the mammalian host. Both have common strategies of establishing a new homeostasis in the host intestinal tract. These strategies include regulating host immunity to permit their survival through the induction of suppressive regulatory T cells ( Tregs ). Also, Short-Chain Fatty Acids (SCFAs) may be a possible another common pathway shared by microbiota and helminths. SCFAs are microbial metabolite that are derived from microbial fermentation of dietary fibers in the colon. Similarly, some helminth infection leads to SCFAs elevation in human. SCFAs can potentiate T regs generation and IL- 10 production in the periphery. Dissecting the multidirectional interactions among intestinal microbes, helminth parasites and their host immune system will hopefully enable the design of new therapeutic strategies to treat metabolic and inflammatory diseases