bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation of Intravenous Vitamin C Injection and Plasma Albumin Level in Burnt Rats (Experimental Animal Study)
Authors: Farid Ashraf Maher , Kamel Ibrahim Hussein , Amin Ebrahim Mohamed , Dief Aya Ibrahim Abdullah Khalifa
Published: October 2021

Background

Burn is tissue injury caused by heat, radiation, electricity, contact with hot objects or chemicals. It’s a global public health problem accounting for an estimated 180000 death annually according to WHO.

Aim of the Work

To detect the efficacy of intravenous vitamin C and plasma albumin level in burnt rats.

Materials and Methods

This study was an experimental study on 14 rats only not including any human and they were divided into two groups: Group A that represented burnt rats that won’t be injected with parenteral vitamin C and Group B represented burnt rats that will be injected with parenteral vitamin C.

Results

There was no statistically significant difference found between two groups regarding albumin level and total proteins level before burn and Post burn 8h. There was highly statistically significant difference between Albumin level and total proteins level before Burn, Post Burn 8h level and Post Burn 24h level.

Conclusion

It is concluded that vitamin C holds potential as a powerful adjunct in burn resuscitation and it may be safe and decreases fluid requirement in the acute phase after burn injury.
The Role of FDG-PET/CT in Staging of Breast Cancer
Authors: Mansour Hesham M , Neyazy Gamal Eldeen M , Abdel Khaleq Yasser I , Elnaggar Ahmed M
Published: October 2021

Background

Breast cancer is the most common non-skin cancer and the second leading cause of cancer related death in women. Breast cancer strikes women of all ages, races, ethnicities, socioeconomic strata, and geographic locales. Once breast cancer is diagnosed, the tumor stage has to be accurately determined before therapy chosen and the prognosis known.

Aim of the Work

to highlight the role of PET-CT imaging in staging of patients with breast cancer.

Patients and Methods

This study was carried out on a total of 51 female patients biopsy-proved to have cancer breast coming to perform PET/CT scans for staging, pre-operative or pre-therapeutic assessment with ages ranging from 27 to 78 years, in specialized private center in Cairo using combined PET-CT machine (Phillips Ingenuity TF PET/CT 128 Slice) from October 2017 to June 2019.

Results

Combined PET/CT staged 3 patients as stage IA, 10 patients as stage IIA, 6 patients as stage IIB, 2 patients as stage IIIA, 3 patients as stage IIIB, 2 patients as stage IIIC and 25 patients as stage IV. Out of 51 patients, combined PET/CT upgraded the staging of 13 patients compared to initial CT staging.

Conclusion

PET/CT is the technique of choice and indispensable tool for evaluation of the patients with breast cancer.
Ultrasound predictive criteria for short term benign thyroid nodular volume reduction after ultrasound guided radiofrequency ablation
Authors: Shehab Khaled Fikry Tawfik , Hussein Ahmed Mohamed , Khattab Rasha Tolba
Published: October 2021

Purpose

This study evaluates the outcome of patients complaining of compressive& cosmetic problems due to benign thyroid nodules after recieving RF ablation with correlation between some ultrasound features of the nodules and their shrinkage and volume reduction.

Methods and material

fifteen patients with benign thyroid nodules causing compressive symptoms (foreign body sensation,neck discomfort or pain) and cosmetic problems.

Results

A total of 15 patients were included with the age rangmg from 22-82 years old the mean was 52.73 years old (SD + 14.37).Among them 12 patients (800 0)were females and 3 patients(20%) were males. There was statistically significant difference between volume of nodules before the procedure with mean volume was 21.13±5.13 and I month after with mean volume I I .96±3.08 and 3 months after the procedure with mean volume 7.70±2.82 with noticeable improvement in nodules with peri and intranodular vascularity showing mean reduction ratio 69.88% after 3 months vs 59.93% and 64 12% of weak peripheral vascularity and intense intra-nodular vasculanty respectively as well as US structure with spongiform nodules showing mean reduction ratio 68.48% at 3 months vs 59.87% and 62.14% for solid &mixed nodules respectively.Mean symptoms and cosmetic score were significantly reduced. Conclusion: This study validated the efficacy and safety of RFA for treatment of benign thyroid nodules and showed correlation between shrinkage and some common US findings.
Knee pain: Ultrasound and MRI correlation
Authors: Eldin Mahmoud Mustafa Mohamed Kamal , HamdyNasef Hana , Shalaby Mennatallah Hatem
Published: October 2021

Background

Knee pain incidence is increasing among the community which has different multiple pathologies. Magnetic Resonance Imaging (MRI) is considered the gold standard imaging modality in diagnosing knee soft tissue injury. Ultrasound (US) is another modality which can be used in diagnosing soft tissue injury.

Aim of the Work

is to detect the reliability of US in diagnosing cases with knee pain as compared to MRI.

Patients and Methods

A prospective study was conducted on 20 patients with knee pain. They were referred from the Orthopedic and/or Rheumatology Department to Radiology department at Ain Shams University hospitals for MRI and US examination of the knee.The age group were from 19 to 59 years.

Results

In this study, 20 patients were examined with majority being males (75%). US was tested against MRI for different soft tissue pathologies.including knee effusion, meniscal pathology (tear, degeneration and extrusion), medial collateral ligament sprain, lateral collateral ligament sprain and Baker’s cyst. There was good agreement between US and MRI in most of these pathologies. US showed an overall sensitivity of 61.7% and specificity of 92.7% with accuracy of 86.9%. The overall PPV and NPV were 66.1% and 91.3% respectively.

Conclusion

Ultrasound can be considered a reliable screening imaging modality in cases of knee pain.
Role of sagittal - oblique technique of MRI in diagnosis of anterior cruciate ligament injuries
Authors: Hafez Abeer Abdel Maqsoud , khaliq Yasser Ibrahim Abdel , Mohamed Marwa Mohamed Abdel Zaher
Published: October 2021

Background

Sagittal-oblique technique clearly shows partial rupture because its’ double angulation follows the specific course of the patient’s ligament, due to approximate orientation of the external rotation of the foot. Sagittal-oblique technique provides a higher number of slices presenting the whole course of ACL

Objective

To value the role of sagittal- oblique technique of MRI adding to the standardized MRI technique in the diagnosis of anterior cruciate ligament injuries.

Patients and Methods

The study was approved by the hospital ethical committee and all patients agreed to participate in the study. We prospectively evaluated 20 patients with MRI examination of the knee. Patients presented with painful knee joint due to trauma of knee soft tissue structures. They were 9 females and 11 males, ranging in age from 26 to 67 years. Mean age is 39.80 years.

Results

Accuracy of standard MRI protocol of the knee comparing to additional technique is identical in detection of a complete ACL rupture. Presentations of the partial ruptures of ACL using sagittal-oblique technique were more sensitive than presentation using standard MR protocol. There was statistically significant difference between MRI detection of the ruptured ACL between additional techniques. Sagittal-oblique technique provides a higher number of MRI slices showing the whole course of the ACL and requires a shorter scan time.

Conclusion

The addition of oblique sagittal technique to the standard MRI imaging improved diagnostic accuracy for detecting partial tear of the ACL. However, oblique sagittal technique is just as precise as the standard MR technique for the evaluation of a complete rupture of the ACL, so it should be used in cases of suspicion of partial rupture of the ACL
Assessment of Rotator Cuff Partial Tear Treatment with Ultrasound Guided Platelet Rich Plasma Injection
Authors: Nassef Hana Hamdy , Louka Amir Louis , Khedr Mohamed Tarek Ali Abdelhamid
Published: October 2021

Background

Rotator cuff tears are a common orthopedic problem, and often these tears are so-called partial tears of the rotator cuff. A partial tear of the rotator cuff is an area of damage or degeneration to the rotator cuff tendons, where the tear does not go all the way through the tendons

Objectives

The aim of the work assessment of rotator cuff partial tear treatment with ultrasound guided platelet rich plasma injection.

Patients and Methods

Single arm interventional study which was conducted in Ain shams university hospitals in the period between March 2020 and October 2020, 10 confirmed cases of rotator cuff partial tear diagnosed by MRI were included in this study. Their ages ranging from 25 to 70 years old.

Results

Our study showed statistically significant improvements in 10 patients in VAS pain score, constant shoulder score, PENN shoulder score and OXFORD shoulder score.

Conclusion

The ultrasound-guided PRP injection for rotator cuff partial thickness tears is a safe, cheap, and easily prepared outpatient procedure which showed competitive, promising and wellproved results. PRP has the potential to heal the muscle-tendon unit of the rotator cuff and may be a primary nonsurgical treatment modality for rotator cuff tears.
CT Pulmonary Manifestations in Patients with Rheumatoid Arthritis: Visual scoring versus pulmonary function
Authors: Eissa Hanan Mohamed , Osman Ahmed Mohamed , sayed Nehal Gamal Eldine El
Published: October 2021

Background

Pulmonary involvement is the most common extra-articular manifestation of Rheumatoid arthritis.

Aim of the Work

To highlight the role of HRCT in detection and characterization of variable pulmonary manifestations that can be encountered in patients with Rheumatoid Arthritis trying to correlate the CT pulmonary manifestations with pulmonary functions using CT scoring system.

Patients and Methods

This was a retrospective study that included 32 patients who were diagnosed to have Rheumatoid Arthritis either outpatients or referred from the Rheumatology Department at Ain Shams University Hospitals to the Radiodiagnosis Department for HRCT chest examination. An acceptance from the ethical committee of Faculty of Medicine - Ain Shams University was obtained to use the data stored on PACs system with the patient’s consent was waived being a retrospective study. All patients underwent HRCT image analysis regarding the CT features and CT score for disease severity. Also, all patients did spirometery for pulmonary function assessment.

Results

Analyzing the data showed a female sex predominance (90.6%). 87% of the patients were diagnosed to have RA for more than 2 years duration. The most common respiratory symptom was dyspnea and the restrictive pattern was the commonest PFT finding. Ground glass pattern was the most common 78.1% followed by reticular pattern which was seen in 68.8% of patients. PFT and HRCT showed a positive correlation regarding the severity.

Conclusion

HRCT is a modality of choice for detection of pulmonary manifestation of rheumatoid arthritis patients with CT scoring can be used to assess the severity of disease and degree of lung involvement which is correlated with pulmonary function test.
Musculoskeletal MRI Findings of Haematological Diseases
Authors: Abdelwahab Sameh Mohammed , Abdelrahman Hazem Ibrahim , Said Pola Ibrahim
Published: October 2021

Background

Hematologic diseases are a group of prevalent and clinically diverse diseases that can affect any organ system. Hematologic disorders frequently involve bone and associated tissues causing significant alterations in the bone marrow and may have relevant side effects on the skeleton. In order to evaluate findings in bone marrow on MR imaging, it is essential to understand the normal composition and distribution of bone marrow and the changes in marrow that occur with age, as well as the basis for the MR signals from marrow and the factors that affect those signals.

Aim of the Work

To describe the musculoskeletal MRI findings in patients with hematological diseases.

Patients and Methods

cross sectional study was conducted in Ain Shams University hospitals on patients confirmed with hematological disease undergoing musculoskeletal MRI.

Conclusion

Magnetic resonance imaging is very beneficial noninvasive modality to evaluate bone marrow and detecting marrow lesions due to its ability to provide information at the level of cellular and chemical composition. Knowing normal marrow components and composition and their variation, as well as of factors that affect MR signal intensity, is important for optimal interpretation of MR images. The signal intensity, morphology, and location of marrow findings on MRI can be used to provide accurate diagnoses and to guide treatment of the discussed hematological diseases.
“Cone Beam Imaging of Cochlear Implants “
Authors: Helal Rania Abdelnasser Mohamed Abdelhaleem , Elshinnawy Maha Abdel Meguid , Vogl Thomas J , Abdelaziz Tougan Taha , Othman Amal Ibrahim Ahmed
Published: October 2021

Objectives

to assess the role of Cone Beam CT (CBCT) in the postoperative cochlear implant (CI) imaging in determining details about the electrode position, insertion depth, angle and other fine anatomical details.

Methods

This retrospective study included 32 patients (34 ears) with post-CI CBCT imaging. All images were anonymized and reviewed by two experienced head and neck radiologists in consensus for the measurements of the implant insertion depth, facial canal (vertical part) diameter, wall thickness and distance between it and the electrode cable, then assessment of the quality of visualization of fine structures as the facial nerve canal, chorda tympani, separate electrode contacts and scalar position of electrodes were done using 4-point scale.

Results

The insertion angles for the electrodes were measured in all the ears with a mean ± SD = 430.24 ± 121.43, the facial canal diameters were measured in 97.1% (33 ears) with a mean ± SD = 1.54 ± 0.33, the facial wall thickness was measured in 79.4% (27 ears) with a mean ± SD = 0.62 ± 0.32, the facial canalelectrode cable distances were measured in 97.1% (33 ears) with a mean ± SD = 1.64 ± 0.50 and the chorda tympani was visualized in 88.2% (30 ears). Perfect visualization of the scalar position of electrodes were encountered in 76.5% (26 ears), separate electrode contacts in 20.6% (7 ears), facial canal in 35.3% (12 ears), facial canal wall in 26.5% (9 ears), and chorda tympani in 41.2% (14 ears).

Conclusion

CBCT is a valuable tool in the postoperative assessment of cochlear implants
CT-angiography and Doppler ultrasonography in the evaluation of carotid artery stenosis: a comparative study
Authors: Khalifa Sherif Mohamed , Mohamed Ahmed Moustafa , Salama Asmaa Magdy
Published: October 2021

Background and purpose

Management of carotid artery stenosis is primarily based on the degree of luminal narrowing. The aim of this study is to compare the results of carotid doppler ultrasound (US) and CT angiography (CTA) for grading of carotid stenosis and for plaque characterization in symptomatic patients.

Methods

This is a cross sectional study with a total number of 35 consecutive patients having 70 carotid arteries for comparison. Grading of carotid stenosis was based on the NASCET criteria for CTA and the carotid consensus panel criteria for US. Each investigator was blinded to the results of the other modality.

Results

The majority of patients were aged from 60 to 69 years with male to female ratio of 3:2. Males were more commonly affected than females. The most common presenting symptom was recent stroke. Risk factors included; diabetes mellites and hypertension. Atherosclerotic ischemic heart disease was a present association. The carotid bulb and proximal ICA were the most common location for carotid plaques. Kappa analysis with 95 % confidence intervals (CIs) was utilized to determine US – CTA agreement. Both modalities showed overall good agreement (kappa = 0.63) and the concordance was better for moderate and higher grades of stenosis than for non-significant stenosis. The disagreement did not exceed one grade difference in our study sample. There was also good agreement as regards plaque morphology, while CTA was more sensitive than US in the detection of calcifications and plaque ulceration.

Conclusion

Doppler ultrasound when performed by an experienced sonographer can be used as a reliable first line modality for carotid stenosis grading and to categorize patients as medical and potentially surgical cases. CTA can be used as a confirmatory method for patients with borderline stenosis, for presurgical planning and for patients with suspected stenosis of the intracerebral circulation.
Ultrasonography and MR Arthrogram in detection of shoulder joint disorders
Authors: Mansour Souad Elsayed Mohammed , Hassan Mohammed Sobhi , Eldin Abdel Motelib Mohammed Gamal
Published: October 2021

Purpose

To know the role of Ultrasonography and MR Arthrogram in detection of shoulder joint disorders

Methods and material

Thirty patients with suspected shoulder joint disorders underwent US,MRI ,MR arthrography shoulder.

Results

All cases with ALAPSA, Bankert, reverse bankert, hillsachs, perthes and SLAP are diagnosed accurately by MR arthrography with sensitivity of (100%) in GLAD ,Supraspinatus tendenopathy ,Supraspinatus tendon tear and IGHL injury sensitivity was decreased to 75%,in cases of paraglenid cysts arthrography did not diagnose any of them as there are no communication between the cyst and the joint

Conclusion

MR arthrography shoulder has a golden rule in diagnosis ,classification of cases of shoulder dislocation ,SLAP injuries and rotator cuff impingement
Comparison Of The Prevalence Of Helicobacter Pylori Infection in Patients With Ulcerative Colitis Versus Normal Egyptian population
Authors: Hamed Waleed Abd El Aaty , Mohammed Hend Mubarak , Helmy Ahmed Fouad , Mohamed Amr Alaa El-Din
Published: October 2021

Background

The prevalence of inflammatory bowels diseases (IBD) increases in societies adapting a Western life style. Thus, it appears that there is an inverse relation between the prevalence of IBD and H. Pylori infection.

Aim

To compare the prevalence of H. Pylori Ag in stool between Ulcerative colitis patients and a normal healthy Egyptian sample.

Patients and methods

The current study was conducted on 70 patients recruited from the IBD study group clinic in Tropical medicine department of Ain Shams University Hospitals .This study group was compared to historical Control samples of healthy Egyptian subjects who were retrieved from a previously conducted study (saad et al.,2008).

The enrolled patients fulfilled the inclusion and exclusion criteria and were divided to two groups

o Study group: All patients who were diagnosed with U.C. based on clinical history, laboratory and endoscopic finding according to ECCO 2017 guidelines (Sandro et al., 2017).

o Control group: Historical Control samples from healthy Egyptian subjects.

Both groups were compared according to basal epidemiologic data and H. pylori Ag in stool positivity, gastrointestinal symptoms, colonscopic and microscopic findings, mainstay treatment lines of U.C., biological therapy and criteria of disease activity .

Results

Most of the enrolled patients in the current study were aged between 20-39 years with 48.6% aging between 20-29 years old and 38.6% between 30-39 years.

While the majority of the cases were females (62.9%), only 11.4% of the included cases were smokers .

We found that of the 70 patients in the cases group with ulcerative colitis, only 34 (48.6%) had positive H. pylori versus 555 reported positive samples in control group (91.7%). So there was a high significant statistical difference between the 2 groups

Conclusion

There is a significant association between H. pylori infection and ulcerative colitis that supports a possible protective benefit of H. pylori infection against the development of U.C. but still further studies are needed
Efficacy and safety of sofosbuvir plus daclatasvir with or without ribavirin in treatment of Egyptian patients infected with chronic HCV (Single Centre Study)
Authors: Shaker Mohammed , Abdella Heba , hefny Zeinab
Published: October 2021

Background and aim

As indicated by the World Health Organization (WHO), Egypt is positioned as the country with the world’s highest prevalence of Hepatitis C virus (HCV). The current study was designed to describe the efficacy and safety of Sofosbuvir plus Daclatasvir with or without Ribavirin in treatment of chronic HCV in a cohort of Egyptian patients who were referred to the viral hepatitis unit in El -Fayoum general hospital.

Methods

This is a prospective descriptive cross sectional study that describes the effect of 12 weeks of daily Sofosbuvir (SOF) 400 mg plus Daclatasvir (DCV) 60 mg with or without ribavirin (RBV) with dose adjustment if indicated. It included 200 patients that fulfilled the inclusion and exclusion criteria and treated in El -Fayoum general hospital, El-Fayoum, Egypt.

Results

In the current study, concerning viral response, SVR12 rate was achieved by 92.5% in the overall patients (185/200); by 98% (98/100) in group I, and by 87% (87/100) in group II. Concerning safety and tolerability, The main adverse effects recorded during and after 12 weeks of treatments were fatigue (46%), (66%); headache (24%), (40%); gastrointestinal upset (15%), (43%); and nausea (10%), (15%) in group 1 and group 2, respectively. Only one female patient in group II developed HCC. All patients completed treatment till the end of course.

Conclusion

The current study suggested that treatment of SOF plus DCV with/without RBV for chronic

HCV patients in Egypt was generally safe, well tolerated, and of high efficacy, reflecting the antiviral potency and high resistance barrier of the combination regimen.
Comparative Study between Neuro-navigation and Intra-Operative Ultrasound in Excision of Intra-axial Brain Lesions
Authors: Fakhr Mohammad A , Hosni Mohammad T , Hammad Omar Y , Elserry Tarek H , El Said Diaa El Dien G
Published: October 2021

Background

The application of imaging during surgery can improve patient outcomes by accurate and thorough removal of lesions while having minimal impact on healthy tissue.

Aim of the Work

to compare the use of neuronavigation to intraoperative ultrasound guidance in excision of intra-axial brain lesion.

Patients and Methods

This cohort study was conducted on 51 patients with intra-axial brain lesion is amenable to gross total resection. The primary outcome was extent of resection assessed using a non-volumetric technique. Other outcomes included the postoperative functional status and the rate of operative complications.

Results

There were 34 patients in the Neuronavigation group and 17 patients in the ultrasound group. The extent of resection was significantly better in the ultrasound group as the extent of tumor resection based on the GTR/NTR/STR method of assessment showed that the IOUS group had statistically significant higher chance of achieving GTR (29.4%) than the navigation group (8.8%). In the IOUS group near total and subtotal resection rates were 17% and 52% respectively. In neuronavigation group 11.8% and 79.4%.

Conclusion

application of ultrasound integrated in Neuronavigation system guidance in surgery excision of intra-axial brain lesions is a useful tool in achieving a higher extent of tumor resection (EOR).
Transsphenoidal Endoscopic versus Microscopic Approach in Treatment of Pituitary Adenomas: CSF Leak and GTR Systematic review
Authors: Omran Ibrahim M , Ibrahim Hamdy , Maamon Emad , Yousry Ahmed
Published: October 2021

Background

Pituitary adenomas (PAs) are the second most common brain tumors, 10% to 20% of all primary brain tumors. Transsphenoidal approach is now the gold standard for treatment of PAs either microscopic or endoscopic.

Aim of the Work

to analyze the collective outcomes from studies comparing the microscopic transsphenoidal surgery (MTS) with the endoscopic transsphenoidal surgery (ETS) regarding gross total resection (GTR) and postoperative cerebrospinal fluid (CSF) leak.

Patients and Methods

we searched PubMed, Google scholar search engine, Cochrane database of systematic reviews, EMBASE and science Direct, using the following keywords “Pituitary adenoma/tumor, endoscopy or endoscopic, microscopy or microscopic, gross total/subtotal/near total/radicular resection/excision, hypophysectomy, debulking, CSF leak/leakage ". The mentioned databases were searched for studies published during period from the 1st of Jan 2015 to 31 Aug. 2020.

Results

Total number of patients in included studies was 1211 of which 621 (51.3%) underwent endoscopic surgery and 590 (48.7%) underwent microscopic surgery. Of 990 patient analysed for GTR, it was achieved in 334 patients (69.4%) in endoscopic group compared with 287 patients (56.4%) in microscopic group. Of 1211 patients, Postoperative CSF leak developed in 30 patients (5.7%) compared with 32 patients (4.7%) in endoscopic and microscopic group respectively.

Conclusion

GTR was found to be slightly higher in the endoscopic group especially in cases of suprasellar and lateral cavernous extensions. CSF leak showed no significant difference between the two groups.
Thoracolumbar spine fractures, short versus long posterior fixation: Guidelines and controversies. A Systematic Review
Authors: Ali Ali K , Hamad Ahmed M , Farghaly Ahmed R , Ghaly Mohamed S
Published: October 2021

Background

Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. Controversies exist regarding the appropriate radiological investigations, the indications for surgical management and the timing, approach and type of surgery.

Aim of the Work

to discuss: Guidelines and controversies of short versus long posterior fixation in management of thoracolumbar spine fractures.

Patients and Methods

20 articles were identified through specified electronic databases. After application of the inclusion and exclusion criteria, 9 comparative studies were finally included in this systematic review. Various other approaches were used in combination with posterior pedicle screw fixation according to the underlying pathology (e.g. Discectomy, Laminectomy, Vertebroplasty, Kyphoplasty, etc.). A total of 194 patients underwent short segment pedicle screw fixation compared to 158 patients who underwent Long segment pedicle screw fixation for various indications. The majority of the included trials were small studies with between 12 and 69 participants. The patients’ characteristics were comparable within each study group. Individual patient data were available from these articles.

Results

A total of 194 patients underwent short segment pedicle screw fixation compared to 158 patients who underwent Long segment pedicle screw fixation for various indications. The majority of the included trials were small studies with between 12 and 69 participants. The patients’ characteristics were comparable within each study group. Individual patients data were available from these articles; longest follow up post operative record was about 71 months; 162 male and 93 female in these studies; the mean age about 38 years; the level of thoracolumbar fracture was: 60 patients at T12,104 patients at L1 and 41 patients at L2.

Conclusion

This review suggest work on the guidelines with evaluating of each case according to age, angels, height, weight (BMI), comorbidities, ability to anaesthesia and types of instability in the patient before as osteoporosis and kyphosis. Degree of angels of cobb and kyphotic angel which are major factors determine if posterior long or short.
Assessment of Tear Meniscus Changes Before and After Dacryocystorhinostomy Using Anterior Segment Optical Coherence Tomography
Authors: Habeeb Ann Wadie , Aziz Mansour Dina Ezzat Abdel , Abdelsalam Shaat Ashraf , Mohammed Nabil Radwa
Published: October 2021

Background

Tear meniscus is one of the most important indices for therapeutic evaluation in treatment for obstruction of the lacrimal drainage system, which can be assessed by slit lamp examination and fluorescein dye disappearance test as a semi quantitative measurement. Recently Anterior Segment Optical Coherence Tomography has enabled noninvasive and quantitative assessment of tear meniscus.

Objective

To evaluate if measurement of tear meniscus by anterior segment OCT(AS-OCT) is a reliable method of assessment of improvement after Dacryocystorhinostomy (DCR) compared to other known methods which include dye disappearance test and lacrimal passages irrigation.

Patients and Methods

A prospective interventional study that included 16 eyes from 15 patients with primary acquired nasolacrimal duct obstruction who received external Dacryocystorhinostomy (ex-DCR) from March 2019 till November 2019, were evaluated prospectively on their tear meniscus height (TMH), tear meniscus area (TMA), and tear meniscus volume (TMV) changes by AS-OCT. Measurements were performed before surgery and 3 months after surgery.

Results

The results showed a highly significant decrease in all tear meniscus parameters (TMH, TMA, TMV) after DCR in patients with primary acquired nasolacrimal duct obstruction (PANDO), we concluded that AS-OCT can evaluate TM noninvasively and quantitatively, therefore it can be used as a reliable method of assessment of improvement after DCR compared to other known methods which include dye disappearance test and lacrimal passages irrigation.

Conclusion

Perioperative TM changes after ex-DCR can be evaluated noninvasively and quantitatively with use of AS-OCT, therefore it can be used as a reliable method of assessment of improvement after DCR, compared to other known methods which include dye disappearance test and lacrimal passages irrigation.
Evaluation of Macular and choroidal Thickness measurements in HCV patients taking Recent anti viral hepatitis C Drugs (daclatasvir / sofosbuvir) Combination
Authors: Yusuf Doaa Saad , Salman AG , Yosef Tarek M , Elzawahry Walid Mohamed , Hashem Walaa
Published: October 2021

Purpose

This study aims to evaluate the effect of oral (sofosbuvir / daclatasvir) Combination on the macular and choroidal thickness of Egyptian patients with chronic hepatitis C virus infection using Optical Coherence Tomography (OCT)

Methods

This study was conducted on 30 subjects recruited from Viral Hepatitis Treatment and Research Centre and examined at Ophthalmology Out Patients Clinics, Ain Shams University Hospital during the period from June 2018 to February 2019. All participants underwent full general and ocular history taking and a precise ophthalmological clinical evaluation including assessment by OCT before starting our Direct Acting Antiviral Drugs (DAAs), sofosbuvir and daclatasvir (SOF/ DAC) combination for 12 weeks then, they reassessed again at the end of the treatment by Spectral Domain optical coherence tomography (SD –OCT) Retina Scan RS - 3000 advance(NIDEK Co., Gamagori Japan) (figure 1).

Results

Our study included 60 eyes of 30 patients with chronic hepatitis C with no evidence of changes on macular and choroidal thickness have been reported at 3 months after treatment onset in all subjects; the difference was statistically insignificant for macular and choroidal thickness.

Conclusions

Our study showed that all the participants who were followed before and after treatment showing that there were no changes on the best corrected visual acuity (BCVA), there were no changes on macular and choroidal thickness observed throughout all the study period.
Comparative Study between Dryness Post Phacoemulsification and Post Extra Capsular Cataract Extraction
Authors: Eldin Mohammed Elgeshy Alm , Rashad Saad Mohammed , Elsaka Ayman Mohamed , Fawzy Samah Mahmoud , ElSamkary Mahmoud Ahmed
Published: October 2021

Purpose

This study aims to detect and compare the severity and pattern of dry eye occurrence after phacoemulsification and extra capsular cataract extraction surgeries.

Methods

Twenty eyes of twenty patients in two groups, ten eyes planned for Phacoemulsification(phaco) and ten eyes planned for Extra Capsular Cataract Extraction (ECCE) enrolled in a prospective comparative study. All patients underwent full history taking and full ophthalmological clinical evaluation including (tear film meniscus height, Schirmer 1 test, tear break up time). Evaluations will be done one week before cataract surgery then three and six weeks after the surgery.Also, goblet cell count is measured twice, before and 6 weeks after the operation.

Results

After both Phaco, andECCE, the changes between means of pre-operative, 3 weeks and 6 weeks visits were significant in tear film meniscus height (p = 0.01) and were insignificant in both Schirmer 1 and tear break up time (p > 0.05). There was a significant deterioration after 3 weeks of surgery in tear film meniscus height followed by significant increase between 3rd and 6th weeks post-operative measurements (p = 0.01). There was a significant difference between the 2 groups in the total change of Schirmer 1 and tear break up time between the6th weeks and the pre-operative measure with more deterioration in group 2. There was no significant difference between the 2 groups in tear film meniscus height 6 weeks post operation.The deterioration in goblet cell count was significantly worse in the ECCE group (mean difference of -22.1±8.5 and was -7.5±5.1 in the phaco group), (p = 0.0005).

Conclusions

Phacoemulsification surgery may aggravate the signs and symptoms of dry eye and affect dry eye test values in patients in short-term but less than ECCE.
Optical Coherence Tomography and Pattern Electroretinography Changes in Egyptian Patients with Major Depressive Disorder
Authors: ElShaarawi Mostafa S , Gaafar Ayman A , Eldin Hisham S. Saad , Ali Randa H
Published: October 2021

Background

Major depressive disorder (MDD) is a common psychiatric disorder that affects nearly 11.1-14.6 % of the population in their lifetime. Pathophysiology and brain imaging findings show that degenerative and inflammatory processes may play a role. Meta-analysis of voxel-based morphometry studies in MDD demonstrated significant gray matter loss. From anatomical and embryological perspectives, the retina can be considered a unique extension of the brain and is able to reflect axonal histopathology. Being unmyelinated, it can provide insight into the pathophysiological processes of diseases with a neurodegenerative element.

Aim

to compare retinal optical coherence tomography (OCT) parameters in a group of MDD patients with a healthy control group and to correlate OCT parameters with pattern electroretinography (PERG) parameters.

Method

a controlled cross sectional study was conducted on 30 MDD patients and 28 age and sex matched controls. Both groups had a full ophthalmological examination, OCT imaging and 7 patients and 11 controls have PERG recorded.

Results

Thinning of the superior retinal nerve fiber layer, thinning of most of the ganglion cell inner plexiform (GCIP) layer, thinning of most of the macular thickness and thinning of macular volume in both eyes were detected. There was a statistically significant positive correlation between the left GCIP layer and the amplitude of the N95 wave. Also a statistically significant negative correlation existed between MDD duration in years with the left eye's average volume of the outer ring of the macula.

Conclusion

Significant retinal changes were detected by OCT in MDD patients supporting the theory of neurodegeneration as a pathophysiology of MDD.
Axial Length and White to White Corneal Diameter in Eyes with Keratoconus
Authors: elwahab Omnia Talaat Abd , Mansour Dina Ezzat , Roshdy Maged Maher Salib , Ismail Ahmed Taha , elwahab Omnia Talaat Abd
Published: October 2021

Objective

To study the axial length (AL) and white to white (WTW) corneal diameter in keratoconus (KC) eyes and compare them to normal eyes.

Methods

Sixty-three eyes of 53 patients were included in this cross-sectional observational study divided into KC group comprised of 28 eyes of 18 patients and control group comprised of 35 eyes of 35 patients based on clinical and tomographic findings. All subjects were examined using rotating Scheimpflug corneal tomography (Pentacam HR; Oculyzer II) for central corneal thickness (CCT), thinnest corneal thickness (TCT), keratometric values, anterior chamber depth (ACD) and lens thickness, and by optical biometry (IOLMaster 500) for axial length (AL) measurements. Vitreous cavity length (VCL) was calculated by subtracting the values of CCT, ACD (internal), and lens thickness from the AL. White to white (WTW) corneal diameter was measured using Placido-based tomography (Topolyzer VARIO).

Results

The mean age was 31.27±8.65 years(30.39 ± 9.31) in the KC group and .(31.74 ± 8.38) in the non KC group. The KC group included 28 eyes their mean spherical equivalent (SE) was -3.16 ± 2.42 and the control group 35 healthy eyes including 23 ametropic eyes with mean spherical equivalent (SE) (-3.95±4.50 D) and 12 emmetropic eyes with mean SE (-0.19±0.40 D). The mean VCL was significantly greater in normal eyes (17.45 ±1.34 mm) compared with KC (16.77±1.18 mm) (P = 0.037), while the mean ACD (internal) was significantly greater in KC eyes compared to normal (P = 0.020) and the lens thickness showed no statistically significant difference. The greater VCL in the normal group was compensated by the greater ACD in the KC group causing the total AL to have no statistically significant difference (normal eyes =24.44 ±1.38 mm and KC eyes= 24.21 ±1.31 mm) (P = 0.513). There was no statistically significant difference in the WTW corneal diameter between KC and normal eyes (11.81 ±0.35 mm in the normal group compared to 11.79 ±0.35 mm in the KC group) (P = 0.835).

Conclusion

VCL was significantly greater in normal eyes compared with those eyes with KC. AL and WTW showed no difference between the two groups.
Endoscopic endonasal dacryocystorhinostomy vs nasolacrimal duct intubation in pediatric nasolacrimal duct obstruction - a comparative study
Authors: Atia Rana , Samy Magda , Elwan Sheriff , Helmy Thanaa , Shaat Ashraf , Nada Ossama
Published: October 2021

Study design;

Pilot randomized controlled study.

Objective

To compare success rates of endoscopic endonasal dacryocystorhinostomy and nasolacrimal duct intubation in congenital nasolacrimal duct obstruction (NLDO) in a trial to define the superiority of either technique.

Patients & Methods

Sixty-six eyes of 61 patients were diagnosed as having epiphora and mucopurulent discharge due to congenital NLDO. The patients were randomly divided into two groups; Group A; 33 eyes of 28 patients (treated by probing and silicone intubation only (NLDI)) and Group B; 33 eyes of 33 patients (treated by endoscopic endonasal dacryocystorhinostomy and silicone tube intubation (EDCR). All tubes were removed 6 months after the operation.

Results

The success rate, defined as complete resolution of clinical symptoms and signs after 6 months of follow up, was 72.7 % in Group A and 81.8% in Group B. Although the success rate was higher in Group B, yet the difference was shown to be statistically nonsignificant. Preoperative symptoms were assessed postoperatively after tube removal. Complete cure had a higher rate of occurrence in Group B than in Group A (27eyes (81.8%) versus 25 eyes of 22 patients (75.8%) respectively). Postoperative positive fluorescein dye disappearance test (FDDT) after tube removal was more in Group B than in Group A (27 eyes (81.8) versus 24 eyes of 21 patients (72.7 %) respectively). In Group A, silicone tubes had to be repositioned due to prolapse in 3 eyes of 3 patients (9.1%) and had to be removed early in 3 eyes of 3 patients (9.1%) due to failure of repositioning. In Group B, silicone tubes did not require early tube extraction before the date of removal in any of the patients. Intraoperative, there was only one case (3.0%) of fat prolapse during EDCR in Group B with no subsequent postoperative complications. Hemostasis did not represent a problem in any of the patients. Postoperative complications occurred more in Group B than Group A (21 eyes (63.6%) versus 13 eyes of 13 patients (39.4 %) respectively). Late complications occurred more in Group B than Group A (18 eyes (54.5%) versus 12 eyes of 12 patients (36.4%) respectively) in the form of persistent epiphora and tube prolapse.

Conclusion

The success rate of pediatric EDCR was higher than that of pediatric NLDI. The difference was statistically non-significant. Complications were comparable between the two groups. The study, being pilot in its comparative aspect between endoscopy and intubation, opens the horizon for further study on a larger group that probably will expand this difference.
COMPARING The EFFICACY AND SAFETY OF TREATMENT WITH FIXED DOSE OF TADALAFIL OR TAMSULOSIN AND THEIR COMBINATION THERAPY IN Patients With BENIGN PROSTATIC HYPERPLASIA and Erectile Dysfunction
Authors: Abdallah Hany Mostafa , Radwan Ahmed , Habib Kirolos Nabil
Published: October 2021

Purpose

To compare monotherapy with tadalafil or tamsulosin and their combination therapy in men with benign prostatic hyperplasia and erectile dysfunction by comparing IPSS score, prostate volume and Qmax and some other outcomes.

Materials and Methods

All patients with lower urinary tract symptoms, benign prostatic hyperplasia and any grade of erectile dysfunction were recruited. They were randomly divided into three groups (50 participants in each group): Group A received 5 mg/daily tadalafil; Group B received 0.4 mg/daily tamsulosin; Group C receieved a combination of 0.4 mg/daily tamsulosin and 5 mg/daily tadalafil. Primary outcomes were prostate volume, prostate specific antigen, post-void residual volume, IPSS score, LUTS severity, Qmax, IIEF and erectile dysfunction severity and secondary outcome was complications.

Results

The mean ± SD of ultrasonographic prostate volume was 61.4 ± 15.1 mL and prostate specific antigen level was 2.4 ± 1.9 ng/dl. Post-void residual level was significantly different before and after the treatment, except for group A. Also, this group had no meaningful difference compared to the other groups in this regard (P > 0.05). There were significant differences between pre- and post-treatment international prostate symptom scores in each group (P < 0.05).

Conclusion: Combination of tamsulosin and tadalafil can improve international prostate symptom scores, international index of erectile function questionnaire scores and Qmax in patients with lower urinary tract symptoms and benign prostatic hyperplasia to more degrees than their separate use. This combination is recommended because of its synergistic effects, well toleration and safety

Conclusion

Combination of tamsulosin and tadalafil can improve international prostate symptom scores, international index of erectile function questionnaire scores and Qmax in patients with lower urinary tract symptoms and benign prostatic hyperplasia to more degrees than their separate use. This combination is recommended because of its synergistic effects, well toleration and safety.
Outcome of Extended Varicocelectomy in Case of High Grade Varicocele
Authors: Essamt Mohamed , Tawfeek Ahmed Mohamed , Tawfeek Abo Faddan Osama Mostafa
Published: October 2021

Background

Varicocele is defined as abnormal dilation and tourtousity of the internal spermatic veins within the pampiniform plexus. It is common among adolescents and may contribute significantly to the risk of subfertility in adulthood.

Objective

To evaluate the outcome of extended varicocelectomy in case of high grade varicocele.

Patients and methods

In all, 30 varicocele cases including 12 left sided and 18 bilateral, comprising 48 spermatic cord units with clinically palpable varicocele and affected semen analysis underwent extended varicocele ligation. Testicular delivery was done in all the cases and assessment of the gubernacular veins was reported. The patients underwent clinical evaluation, scrotal doppler ultrasonography, as well as semen analysis to detect varicocele recurrence, hydrocele formation and early changes in semen parameters. The postoperative evaluation period was 3 months.

Results

No varicocele recurrences were clinically detectable after our surgical approach, No hydrocele formation, and There was improvement in the parameters of semen analysis in the entire patients presented with infertility associated with varicocele as regard improvement in the count, motility, and decrease in the abnormal forms 3 months after varicocelectomy.

Conclusion

Extended varicocele ligation with delivery of the testis achieve good surgical outcome with minimal varicocele recurrence and hydrocele formation, and offer beneficial effect on semen parameters.
Immunohistochemical expression of HGF and cMET in meningiomas
Authors: Helal Thanaa E , Ragheb Faten W , Hewedi Iman H , Abd Raboh Nermine M , Halim Mariam I
Published: October 2021

Background

Meningiomas are the most common intracranial neoplasm together with gliomas; but unlike gliomas they are still graded according to their histopathological picture. Many growth factors and tyrosine kinase receptors have been studied in meningiomas in an attempt for prognostic stratification of patients, also to find a suitable targeted therapy for meningiomas.

Aim of the study

To correlate the immunohistochemical expression of HGF and cMET with the different WHO grades of meningioma in addition to brain invasion.

Materials and methods

This study included 60 cases of meningiomas (WHO grade I, n = 30 and WHO grade II & III, n = 30), brain invasion was present in 14 cases.

Results

HGF, cMET & HGF/cMET co-expression were positive in 60.0%, 65.0% and 58.3% respectively of the cases; WHO grade I meningioma showed positivity in 30.0%, 33.3% and 30.0% of the cases respectively in contrast with 90.0%, 96.7% and 86.7% of the cases of WHO grades II & III meningiomas respectively. The relation was statistically highly significant (p- value: <0.001). As regards cases with brain invasion the expression of HGF, cMET and HGF/cMET co-expression was found in 92.9%, 100.0% and 92.9% respectively in comparison with 50.0%, 54.3% and 47.8% in the rest of the cases of meningiomas respectively; the relation was statistically significant (p- value: 0.004).

Conclusion

The results suggest that HGF/cMET pathway may play a role in the progression of meningiomas from WHO grade I to higher grades II & III.
Screening for Cow Milk Allergy Among Young Egyptian Children
Authors: El-Sayed Zeinab A , El-Owaidy Rasha H , Abd El-Lateef Hanan M , Hammouda Ahmed SA
Published: October 2021

Background

There are insufficient published data on the prevalence of cow's milk protein allergy (CMPA) in Egypt.

Aim of the Work

The study aims to estimate the frequency of CMPA among young Egyptian children in a trial to delineate the magnitude of the problem in our population.

Methods

A cross-sectional, observational study was conducted on 500 young Egyptian children from the general population aged from 6 months to 5 years; 200 males and 300 females. Children were subjected to history taking and clinical examination. Suspected cases with suggestive clinical history of CMPA were subjected to skin prick test (SPT) with standardized cow’s milk protein allergen extract and open oral challenge test (OCT).

Results

In the present study, 6.2% of screened children had positive clinical history suggestive of CMPA, 35.5% of them had positive SPT and 51.6% had positive OCT. Based on clinical history and OCT, 3.2% were documented to have CMPA, 3% had undocumented CMPA or low probability of CMPA and 93.8% had no CMPA. The highest rate of initial onset of CMPA is seen before the first year of life (96.8%) and 81.3% of children with positive OCT were formula/mixed-fed. The clinical manifestations in infants with suspected CMPA were variable, and the main presenting feature was gastrointestinal tract manifestations (42%). The IgE-mediated CMPA was more common and constituted 56.3% of the CMPA cases.

Conclusion

The frequency of CMPA among Egyptian children up to 5 years of age is comparable to the reported frequencies worldwide. IgE-mediated CMPA accounts for more than 2/3 of the patients with proven CMPA in this study.