bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Hepatic Steatosis Before and After Treatment In Egyptian HCV Patients Treated With DAAs Using Non Invasive Parameters
Authors: Yosef Tareq M , Ibrahim Wesam A , El-Nakeep Sarah A , ElGhandour Ahmed M , Gerges Mariam W
Published: October 2021

Background

Hepatitis C virus (HCV) is a major health problem worldwide. More than one million people die each year from hepatitis C virus (HCV) related diseases.

Aim of the Work

to evaluate the effect of direct acting antiviral drugs on hepatic steatosis in naïve HCV chronically infected Egyptian patients after reaching SVR12.

Patients and Methods

study was carried out on 100 treatment naive patients with chronic infection of HCV attending the out-patient clinic. The patients were diagnosed having HCV by detecting HCV antibodies by ELISA & PCR for HCV RNA at The Gastro-enterolgy and Hepatology Department, Ain Shams University and Kobry El Koba Military Hospital between August 2017 till February 2019.

Results

The mean TG, mean s. cholesterol and APRI Score decreased significantly showing a high statistical significant difference between baseline and SVR12. The mean HDL and LDL significantly increased showing a high statistical significant difference between baseline and SVR12. NAFLD Score increased from baseline to SVR12 showing a statistical significant difference in NAFLD Score between baseline and SVR12. Fibroscan median mean decreased showing a highly statistical difference in Fibroscan Median between baseline and SVR12. Out of 100 patients, cirrhosis regressed to F3 in 33 patients, F2 in 3 patients and didn’t regress to F1 in any patient, while the majority (43 patients) remained as F4 at SVR12.

Conclusion

APRI Score mean and Fibroscan median mean were significantly decreased, while NAFLD Score was increased among the studied groups from baseline and SVR12.
Effectiveness and Safety of Ombitasvir/Paritaprevir/Ritonavir in Treatment of Chronic Hepatitis C Egyptian Hemodialysis Patients
Authors: Abdel-Mohsen Waleed A , Ahmed Ossama A , Teama Nahla M , ElGhandour Ahmed M , El Sayed Sarah M
Published: October 2021

Background

prevalence of hepatitis C virus infection in patients with renal diseases is higher compared to the general population FDA has approved ombitasvir/paritaprevir/ritonavir for the treatment of patients with severe renal disease.

Aim of the Work

to evaluate the efficacy and safety of Ombitasvir/Paritaprevir/Ritonavir in treatment of chronic Hepatitis C Egyptian Prevelant Hemodialysis patients to compare it with the same treatment result in chronic Hepatitis C Egyptian patients with normal renal functions.

Patients and methods

Written informed consent was obtained from all patients participating in the study .This case-control study was conducted on one hundred patients with confirmed diagnosis of HCV positive infection at Center of National Committee for Control of Viral Hepatitis [NCCVH] at Ain Shams University Hospital. Patients were divided into two groups Group I (Control Group): 50 Chronic Hepatitis C virus patients with normal renal functions Group II (Case Group) 50 chronic Hepatitis C virus Prevelant Hemodialysis patients on regular hemodialysis.

Results

95.1% of Prevelant Hemodialysis patients achieved Sustained Virological Response (SVR) while 100% of patients with normal kidney functions achieved Sustained Virological Response. Most common side effects were Hemoglobin drop, GIT disturbance, Sever fatigue and Itching.

Conclusion

Ombitasvir, paritaprevir, and ritonavir considered as a safe and effective in treatment in HCV infection in patients on regular hemodialysis.
Study of neutrophil function in different age group
Authors: Rashad Sherein Mohamed , Aboali Fawzeia Hassan Ahmed , Fares Mohamed Nazmy , Shahin Rasha Yousef , Elmahdi Amira Ramadan
Published: October 2021

Background

Neutrophils are the body's first line of defense against microorganisms, and a critical effector cell in both innate and humoral immunity. The immune system experiences profound changes with aging, thereby increasing the susceptibility to infectious diseases. Neutrophils from aged hosts consistently show impairments in the phagocytosis of opsonized bacteria, and the ability to kill phagocytosed microorganisms.

Objectives

determine oxidative burst function of neutrophil in in different age group.

Methods

cross sectional descriptive study, carried out in obesity clinic Ain shams university

Results

we found that Peak fluorescence intensity results is 95.5±2.6 in age group 20-40yr, 94.8±2.6 in age group 41-60yr and 86,8±15.1 in age group ≥61yr.The Percent neutrophil stimulation is 74.2 ±10 in age group 20-40yr, 74.8±9.2 in age group 41-60yr and 69.6± in age group ≥61yr .

Conclusion and Recommendation

there is a slight decreased in the peak fluorescence intensity and the Percent neutrophil stimulation with ageing. We recommend more healthcare of elderly to improve their immunological status.
Study of serum Micro-RNA 221 Expression in Patients with Thyroid Nodules and Its Relation to Outcome
Authors: Bayomy Sherief Samy , Botros Raef Malak , Elsherbini Alyaa Ahmed , Ali Hanan Mohamed
Published: October 2021

A major dilemma in the diagnostic management of thyroid nodules is to determine whether it is a benign or malignant lesion and hence to determine decision for surgery. The majority of individuals with thyroid nodules are asymptomatic. The current first line of evaluation of thyroid nodules encompasses thyroid hormone laboratory tests, and ultrasonography of the thyroid gland, fine-needle aspiration (FNA) biopsy is often used to rule out cancer in thyroid nodules, in 20–30% of cases, however, FNAB yields indeterminate cytological results and suspicious for malignancy. Surgery was classically recommended for such indeterminate nodules for their risk of malignancy, which, overall, is about 25% when

confirmed histopathologically upon thyroidectomy. As a result, about 75% of patients with cytologically indeterminate thyroid nodules would undergo unnecessary thyroid surgeries for nodules that prove to be benign only after surgery. Recent advances in research on thyroid carcinogenesis have yielded applications of diagnostic molecular biomarkers and profiling panels in the management of thyroid nodules. Among these markers are MicroRNAs (miRs) are small RNA sequences (19–25 nucleotides) that function to regulate the expression of genes. In this paper we aim to detect a possible of Micro-RNA 221 expression in sera of Patients With thyroid nodules and its relation to outcome after surgery.
Value of Plasma Squamous Cell Carcinoma Antigen-IgM Immune Complexes (SCCA-IgM IC) as a Novel Biomarker for Monitoring Hepatocellular Carcinoma Treatment Outcome
Authors: Yosef Tarek M , Nasser Haytham M , Kabiel Walaa A.Y , El-Ansary Amira R , Esmail Mohamed E. H , Salama Mohamed M
Published: October 2021

Background

Assessment of the levels of Squamous Cell Carcinoma Antigen-IgM Immune Complexes (SCCA-IgM IC) as a serum biomarker to assess the prognosis and treatment outcome of HCC after locoregional treatment

Aim of the work

Evaluation of plasma squamous cell carcinoma antigen-IgM immune complex (SCCA-IgM IC) level as a biomarker to predict response to treatment with radiofrequency ablation (RF) and/or trance arterial chemoembolization (TACE) in HCC patients.

Patients and Methods

This study was conducted at the Internal Medicine department, Faculty of Medicine, Ain Shams University, during the period from July 2016 to November 2018 on 60 sequentially recruited patients with HCC undergoing locoregional treatment (RF and/or TACE). Patients were divided into two groups, Group A: 40 patients underwent TACE, Group B: 20 patients Underwent RF, all patients were followed up at 3 and 6 months post treatment. Patients who were excluded, those with HCC with late stage of the BCLC (Barcelona clinic liver cancer) staging system, patients with decompensated liver disease (Child-Pugh C), Hepato-renal syndrome or renal insufficiency, patients who had history of organ transplant or previously treated HCC.

Results

SCCA IgM IC serum level was significantly lower in patients without recurrence post TACE than patients with HCC recurrence at 3 and 6 months post treatment. SCCA IgM IC showed promising results especially when combining with AFP in diagnosis and monitoring of treatment response of HCC

Conclusion

the use of SCCA IgM IC in combination with AFP serum level may prove to be useful in assessing prognosis of HCC locoregional treatment
Role of Fibroblast growth factor 21 (FGF-21) as a prognostic marker for fetal and maternal complications in patients with gestational diabetes mellitus
Authors: Halawa Mohamed Reda , Kolaib Magdy Hassan , El-Halawany Salah Hussein , Marwan Dina Ahmed , Shaheen Ola Mohamed Mostafa
Published: October 2021

Background

Gestational diabetes mellitus (GDM) defined as glucose intolerance with onset or first diagnosis during pregnancy. While GDM usually resolves following delivery, it can have long-lasting health consequences, including increased risk for type 2 diabetes (T2DM) and cardiovascular disease (CVD) in the mother, and future obesity, CVD, T2DM, and/or GDM in the child. This contributes to a vicious intergenerational cycle of obesity and diabetes that impacts the health of the population as a whole.

Fibroblast growth factor 21 (FGF21) is a hormone that is expressed predominantly in the liver, but also in other metabolically active tissues such as pancreas, skeletal muscle and adipose tissue. An elevated FGF21 level is also an independent predictor of T2DM. GDM and T2DM are proposed to have similar underlying pathophysiologies, raising the question of whether a similar relationship exists between FGF21 and GDM as it does with T2DM.

Objectives

assess the role of Fibroblast growth factor 21 (FGF-21) as a prognostic marker for maternal and fetal complications in patients with gestational diabetes mellitus (GDM).

Patients and Methods

A case control study that was conducted on 50 patients diagnosed with Gestational Diabetes Mellitus and 50 control subjects at Diabetes and Obstetrics outpatient clinic and inpatient ward at Ain Shams university hospitals in the period between December 2018 and July 2019. Patients diagnosed with gestational diabetes mellitus (GDM) at 24-28 weeks of gestation were included in this study.

Results

FGF 21 levels varied significantly with blood sugar values where higher levels of FGF 21 levels were found in patients with GDM with study results showing that FGF 21 can be used as a diagnostic marker for GDM at levels above 121 pg/ml with sensitivity 84% and specificity 92%.

Conclusion

FGF 21 can be used as a diagnostic marker for gestational diabetes. Further studies needed for better correlation between FGF 21 levels during pregnancy and maternal outcome.
Evaluation of the effect of glycemic control on the Growth and its relation to Insulin like growth factor binding protein type 3 in a sample of prepubertal Egyptian children with type 1 Diabetes Mellitus
Authors: Halawa Mohamed R , El-Sherbeeny Aliaa A. Abdo , Elhalawany Salah H , Alesi Mohammed D
Published: October 2021

Background

PrePubertal children with type 1 diabetes mellitus are shorter than their non- diabetic peers. we aimed to evaluate the role of HbA1c and IGFBP-3 in this phenomenon.

Aim of the work: The aim of the study

was to evaluate the effect of glycemic control on the growth and IGFBP-3, represented by height, weight, height and weight percentiles for age in a sample of prepubertal Egyptian children with T1DM.

Patients and Methods

This study was a cross sectional study conducted on 80 pre-pubertal Egyptian children, divided into 25 Males and 25 Females with T1DM and 30 age matched controls (15 Males and 15 Females), the participants were recruited from the Outpatient Clinic of the Pediatric Department of Ain Shams University Hospitals and the National Institute of Diabetes and Endocrinology in Cairo, Egypt during the period from July 2018 to August 2019. Anthropometric measures including height and weight were obtained and used to calculate the height and weight percentiles using the CDC calculators. HbA1c as well as IGFBP-3 levels were tested.

Results

The mean age (years) of the participants was (9.671±2.24) for male patients, (9.22 ± 2.19) for female patients and (8.39 ± 2.034) for controls. The height found to be lower in the children with T1DM when compared to the disease-free controls with median values of (129.287 ± 13.410) in male patients, (127.727 ±10.155) in female patients and (136.760 ± 13.431) in the controls. the height and weight percentiles (%) were found to be lower in the children with T1DM when compared to the disease-free controls, the height percentile with median values of 14.54 (IQR 27.95) in male patients, 17.93 (IQR 29.20) in female patients and 87.07 (IQR 20.48) in the controls. the weight percentile with median values of 40.68 (IQR 40.83) in male patients, 30.64(IQR 35.59) in female patients and 85.18 (IQR 20.17) in the controls. A negative correlation between HbA1c (%) and serum IGFBP-3 (ng/ml), height and height percentile were found with (0.014, 0.049 and 0.012) as well as a positive correlation between serum IGFBP-3 and height, height and weight percentiles (%), were found with (,0.004, 0.009 and 0.005 respectively). Serum IGFBP-3 levels were also found to be significantly lower in patients (P < 0.001) with a mean value of (198.6 ± 45.335) in male patients and (168.4 ± 44.317) in female patients and (285.333 ± 61.936) in the disease-free controls.

Conclusion

Serum IGFBP-3 levels (ng/ml) as well as growth are negatively affected in prepubertal children with T1DM in relation to the glycemic control.
Effect of Dialysis Modality on Bone Disease in patient with End Stage Renal Disease
Authors: Alwahab Saeed Abd , Anwar Waleed , ElNassier Mostafa Abd , Aboalfarh Mohammed Elsaeed
Published: October 2021

Background

The kidney plays a vital role in the metabolism of minerals and bone health. It is not only the target organ of several regulating hormones such as parathormon (PTH) and fibroblast growth factor-23 (FGF-23), but it is also the main organ that activates vitamin D. Calcium and phosphorus are fundamentally important in a wide array of biological functions. Abnormalities in calcium, phosphorus, parathyroid hormone (PTH), and vitamin D metabolism (usually referred to as disordered mineral metabolism) are common in patients with (CKD).

Aim of the work

Comparing the effect of hemodiafiltration (HDF) versus conventional Hemodialysis on bone markers.

Patients and Methods

The study was performed on 50 patients in Ain Shams University Specialized Hospital with end-stage renal failure treated by means of chronic hemodialysis (n = 25) and hemodiafiltration (n = 25). Inclusion criteria were end stage renal disease patients on regular hemodialysis for > 6 months, their age> 18 years old, no recent infection (normal CRP), cardiac or vascular access complication, none of the patients had history of bone disease, fracture or malignancy. As regarding blood transfusion and drug intake (affect bone metabolism or hemostasis) had not administered for 1 month perior to study.

Results

Both groups had lower levels of serum creatinine before and after sessions of HD or HDF but Hemodialysis (HD) patients has higher levels of phosphate and bone ALP, than patients on HDF.

Conclusion

Hemodiafiltration (HDF) has better effect on bone metabolism than Hemodialysis (HD).
Safe Ramadan Fasting in Patients with Type I Diabetes Mellitus
Authors: Abushady Manal Mohammed , Abdel-Salam Mona Mohamed , Eid Yara Mohamed , Saad Mo'men Bahaa El-Din
Published: October 2021

Background

All healthy, adult Muslims are obligated to fast from sunrise to sunset for one lunar month each year. During this time, they have to abstain from food, water, beverages, smoking, oral drugs and sexual intercourse. A large multicentred, epidemiological study in 13 Muslim countries also revealed that 43% of people with Type 1 diabetes and 86% of people with Type 2 diabetes observed the fast during Ramadan. Previously, an education programme in London has attempted to provide advice and support locally to Muslim patients with diabetes, who choose to fast during the month of Ramadan.

Objective

Safety & efficacy of diabetes health education programs in Ramadan fasting in people with T1DM.

Methods

The study was conducted on 60 Type 1 diabetic patients intended to fast Ramadan 2017 with average fasting hours 16 hrs. The patients were recruited form the Diabetes outpatient clinic at Ain-Sham University hospitals. All participants (60 subjects) received a basic health education program which was based on Conversational MAP (Living with diabetes). Then participants were subdivided into 2 equal groups each of 30 subjects: Group 1 received Modified IDF health education program for Ramadan fasting. Group 2 received Ramadan Conversational MAPS. Only 29 patients in group 1 and 24 patients in group 2 completed the study, while other 7 patients who attended pre-Ramadan health education sessions but were lost to follow up sessions during and after Ramadan, so they were excluded from the study.

Conclusion

Health education make Ramadan fasting more safe in those patients with type-I diabetes whatever the method of education.

Results

Speaking of effect of health education programs on safe Ramadan fasting, glycemic control & less frequent hypoglycemic episodes sһowed significant decrease in FBS before and after Ramadan in both study groups witһ a mean difference in FBS are 24.517 mg/dl and 61.833mg/dl IDF & MAPS groups respectively .
Study of Disturbed Eating Behaviors in Children with Attention Deficit Hyperactivity Disorder
Authors: Essawy Heba E , Abdelgawad Ahmed A , Khamis Marwa E , Zakaria Alaa
Published: October 2021

Background

There is emergent evidence that disturbed eating behaviors, including emotional eating and obesity, co-occur with attention deficit hyperactivity disorder (ADHD) in children. The current study aims to examine the link between ADHD symptoms, eating behaviors and obesity in ADHD children.

Patients and Methods

50 ADHD children diagnosed by Conners scale were included. They completed the Emotional Eating scale adapted for children (ESS-C) to evaluate eating in response to emotions.

Parents completed the Children’s Eating Behavior Questionnaire (CEBQ) to assess children’s eating behavior. Multivariable regression analysis was used to detect the most independent factor for higher Body mass Index (BMI) risk. Results: Higher rates of overweight/obesity were detected among ADHD children than among normal population. Also, higher Conners global index was associated with higher BMI z-scores. Both Inattentive and combined types were linked to higher BMI, while hyperactive type with lower BMI. Regarding eating behaviors, a positive association between food approach and BMI, and a negative association between food avoidant and BMI z-scores was found. Similarly, there was a noteworthy positive relation between emotional overeating and BMI. 68% of ADHD children were high emotional eaters, mainly inattentive and combined types. Others, mainly hyperactive type, were low emotional eaters. Only ESS-C total score was confirmed as independent factor for higher BMI risk.

Conclusion

Our findings provide evidence that emotional overeating and food approach eating behaviors are common among ADHD children with higher BMI associated with them. Future studies for better understanding of this overlap will enhance potential interventions.
Psychiatric Comorbidities Of Video Games Addiction Among Egyptian Medical Students
Authors: Abd El-Meguid Hammed Marwa , Elrassas Hanan Hany , Soliman Amenah
Published: October 2021

Background

To assess psychiatric comorbidities with video games addiction among medical students of faculty of medicine, Ain Shams university.

Methods

This is a descriptive cross-sectional study. which examined the relationship between videogaming addiction scale subcategories and psychiatric co-morbidities in the studied subjects. The studied subjects were assessed by Fahmy & Sherbini sociodemographic scale, lemmens scale and ICD-10.

Results

The results showed that the subjects who were having mania were 2 subjects (6.7%), 4 subjects suffering from depression (13.3%), 5 subjects suffering from cyclothymia (16.7%), 19 subjects were free from psychiatric co-morbidities (63.3%)

Conclusions

video gaming addicts have psychiatric comorbidities that warrants awareness of clinicians and families.
Suicide Probability Among Tramadol Addicts
Authors: Mohamed Ahmed Saad , Mohsen Nesreen Mohammed , Ismail Lobna AbuBakr , Mahmoud Ayat Ullah Mazloum
Published: October 2021

Background

The magnitude of the problem of substance use in Egypt has been growing lately. Substance use disorders have been associated with depression and suicide, as well as impulsivity and specific personality traits. Suicide is closely linked to the substances use. Therefore it is very important to confirm the factors that affect the possibility of suicide.

Aim of the Work

This study aimed at evaluating suicide risk and its correlation with each of personality disorders and severity of addiction in a sample of 72 tramadol addicts from outpatient clinic of Institute of psychaitry Ain Shams University hospitals.

Patients and Methods

This is a descriptive Cross sectional study conducted in outpatient clinic of Institute of psychaitry Ain Shams University hospital. The present study aimed at analyzing the demographic data of 72 tramadol addicts, over six months period from January 2018 to August 2019. The severity of the addiction problem among those patients was assessed using Addiction Severity Index (ASI), suicidal probability was assessed using suicide probability scale (SPS), Structured Clinical Interview for DSM-VI Axis II (SCID-II) for assessing personality disorders and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I).

Results

The results showed that 32 (44.44%) of the patients had a risk of suicide probability. Also there was a statistically significant difference between risk of suicidal probability and personality disorders especially antisocial personality. It was found that the need for more power for work and pleasurable effects were the most risk factors for tramadol addiction.

Conclusion

Suicide probability was found to be (44.44%) among the studied tramadol addicts. The risk of suicide probability among them was found to be significant in each of the following: antisocial personality disorder, longer duration of addiction, being single and positive family history of addiction. Attention should be paid to include the assessment of suicidal risk as part of routine assessment of addicts.
Value of vessel wall magnetic resonance imaging in the diagnosis and management of cerebrovascular diseases
Authors: Zaki El-Dine Hany M , Abbas Yasser A , Elewa Mohammad K , Farag Sherien M , Mohamad Khaled E
Published: October 2021

Background

Intracranial atherosclerosis, one of the leading causes of ischemic stroke, is associated with an increased risk for recurrent stroke and dementia.

Objective

This work was carried out to assess suspicious lesions detected by Magnetic Resonance Angiography (MRA) and Computed Tomgraphy Angiography (CTA) for further evaluation by vessel wall MRI .

Patients and methods

This study was conducted on 16 patients who were admitted to Ain Shams University Specialized Hospital with establilished diagnosis of stroke (11 patients with intracranial atherosclerosis, 3 patients with CNS vasculitis and 2 patients with Moya-moya disease ) performing MRI brain including magnetic resonance angiography (MRA) that showed intracranial stenosis, who then referred to Misr Radiology Center for the evaluation of intracranial vasculopathies by vessel wall MR Imaging using 3.0-tesla (T) field strengths.

Results

The results showed statistically significant difference between groups as regard to significant intracranial stenosis (>50%). It was prominent among moya moya disease group (100.0%) followed by intracranial atherosclerotic groups (81.8%), whereas CNS vasculitis group shows mild intracranial stenosis (0.0%).

Conclusion

Intracranial vessel wall MR imaging is an adjunct to conventional angiographic imaging
Usefulness of Carcinoembryonic Antigen (CEA) in Evaluating Response to Chemotherapy in Patients with Advanced Non-Small Cell Lung Cancer
Authors: Abdelwahab Sherif Ahmed , Salem Dina Ahmed , Elmaraghi Caroline Magued , Hassan Alaa Naguib Mohammed
Published: October 2021

Background

Lung cancer represents the top cause of death and the most common cancer worldwide. In the United States, lung cancer is the second most common cancer accounts for 12.9% of new cancer diagnoses and 27.4 of all cancer deaths. Non small cell lung cancer (NSCLC) represents up to 80% of all lung cancers which divided into two major types: squamous cell carcinoma (SCC) and nonsquamous cell carcinoma (NSCC, including adenocarcinoma, large-cell carcinoma, and other subtypes).

Aim of the Work

To assess the correlation between CEA (carcinoembryonic antigen) levels and response to platinum-based chemotherapy assessed by RECIST criteria of advanced non-small cell lung cancer patients.

Patients and Methods

This is a prospective study conducted between November 2018 and July 2019, 30 consecutive patients with advanced NSCLC previously treated with at least one line of chemotherapy were prospectively enrolled in thoracic malignancies department in Ain-Shams university hospital and Ismailia Teaching Oncology Hospital. The study was approved by the ethics committee at the faculty of medicine, Ain Shams University.

Results

In our study we evaluated response by CTs according to RECIST criteria and considered patients with clinical response (PR and SD) as responders and patients with PD as non-responders.

Conclusion

Our study found correlation between CEA and radiological response and patients with CEA reduction equal or more than 18.5% have objective response to treatment with Sensitivity and specificity 66.67% and 85.71% respectively.
A Comparative Study of Epidemiology, Clinicopathologic Features and Outcome of Colorectal Cancer Patients between Ain Shams University Hospitals and Luxor International Hospital
Authors: Kamel Tarek Hussein , Farag Amr Lotfy , Ahmed Dr/Sherif Hassanin , Hanna Chresteen Talaat Samy
Published: October 2021

Background

Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide.

Objectives

The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years.

Patients and Methods

The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015.

Results

There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group.

Conclusion

The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.
Retrospective Analysis of the Prognostic Factors That Influence Treatment Response and Survival of Patients with Cancer of Unknown Primary
Authors: Abdlelhafeez Zeinab , Ragab Dina , Hussien Nervana , Tabakh Fatma El –
Published: October 2021

Background

Cancers of unknown primary site (CUPs) are heterogeneous group of metastatic tumors for which a standardized diagnostic work-up could not recognize the site of origin at the time of diagnosis. Cancer registries around the world report the incidence of CUP in the range of 3%–5% of all malignancies, worldwide the overall age-standardized incidence per 100.000 people per year is 4–19 cases. CUP therefore ranks among the top 10 commonest malignancies. CUP occurs equally in both males and females, at average age 60 years old. Incidence of CUP in Egypt is 6.1%in males and 5.5% in females.

Aim of the Work

to retrospectively identify the prognostic factors that influence treatment outcome and survival of patients diagnosed with cancer of unknown primary treated patients at Clinical Oncology departments at Ain Shams University Hospitals (ASUH) and Helwan University Hospitals by retrospective analysis.

Patients and Methods

At the department of clinical oncology, Ain Shams University, 102 patients with cancer of unknown primary were identified in the period between January 2012 and December 2017, all patients data was collected and reviewed.

The primary end point of this study is to identify different prognostic factors that influence treatment response and OS in 102 patients with CUP in the period from January 2012 to December 2017.

Results

Patients with PS 1, with no comorbidities showed better treatment response, also Patients younger than 65year, presented with PS1, with no comorbidity had longer survival.

Conclusion

CUP has a poor prognosis. Some prognostic factors that affect response to treatment and survival in these patients, which may be identified.
Prospective Analysis of Serum HE4 as an Independent Prognostic Factor in Non Small Cell Lung Cancer
Authors: Wasly Nancy Tarek El , Abdalla Hatem , Kady Mohamed El , Moneim Waleed Abd El , Khazragy Nashwa El , Saeid Ahmad
Published: October 2021

Background

HE4 is expressed in most lung adenocarcinomas and in a significant number of squamous, small cell and large cell carcinomas of the lung, suggesting that it could be used as a diagnostic and/or prognostic factor to refine the standard pathologic analysis.

Methodology

Data was collected prospectively in the form of blood sample withdrawn from patients with NSCLC confirmed with pathology presented to bronchogenic clinic in Oncology department of Ain Shams University in pretreatment state & from healthy controls with matched age & sex. The Human HE4 (Epididymal Protein 4) was measured in serum samples using Enzyme linked immunosorbent assay [ELISA], the assay was performed using Human HE4 9Epididymal protein 4) ELISA kit, cat no: EH0365 (Fine Test, Wuhan Fine Biotech Co., China).

Results

77 patients with NSCLC cases & 30 healthy controls were enrolled in the study. Serum HE4 showed to have to a diagnostic tendency were its value in NSCLC cases was from 42 to 130 pmol/l (median= 72pmol/l). but in controls its value was from 10 to 67 pmol/l (median = 35 pmol/l), which was highly statistically significant (P = 0.001). The cut off value of serum HE4 was 60 pmol/l with sensitivity 77% & specificity 96% (95% CI 0.9-1). Serum HE4 showed to be a poor prognostic marker to OS with statistically significant difference were those with pretreatment serum HE4< 72 pmol/l mean survival time 17.6 months in comparison to the group with pretreatment serum HE4 > 72pmol/l mean survival time 13.2 months (p = 0.02).

Conclusion

There is a negative correlation between Serum HE4 in NSCLC & overall survival, the highest the serum level the shortest the survival. This result can present serum HE4 as a novel prognostic & probably diagnostic marker for NSCLC.
Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures
Authors: Morsi Ahmed Mohamed , Shafik Tameem Mohamed , Hassan Ahmed Kamal Mohamed
Published: October 2021

Background

During the last two decades, our understanding of fracture healing has evolved rapidly. Bone is one of the few body tissues that can heal without forming a fibrous scar and, as such, the process of fracture healing recapitulates bone development and may be considered a form of tissue regeneration. The complex cell and tissue proliferation and differentiation processes involved in fracture healing are regulated by growth factors, inflammatory cytokines, antioxidants, hormones, amino acids, and other nutrients. Objective: To identify changes in serum level of calcium, ionized calcium, alkaline phosphatase and parathyroid hormone according to mode of trauma (low and high energy) in forearm fractures and their role in fracture healing.

Patients and Methods

50 Patients with forearm fracture were prospectively recruited from the Accident and Emergency Department of Trauma Surgery, El Zaitoun specialized hospital within 48 hours of sustaining the fracture. Patients included in the study were asked to avoid calcium supplementation during fracture healing.

Results

Mean PTH was elevated in both groups at Day 1 with low energy group was insignificantly higher than high energy group, whereas after 8 weeks mean PTH level decreased in both groups but in low energy group mean PTH level was significantly higher than high energy group. Mean ALP level increased in both groups at Day 1 whereas in low energy group it was insignificantly higher than that of high energy group, After 8 weeks mean ALP level insignificantly decreased to normal level in both groups. Mean serum calcium level was below normal level in both groups where it was insignificantly higher in high energy group than that of low energy group which increased after 8 weeks in both groups but remained elevated in high energy than low energy group. Mean serum ionized calcium level was below normal level at Day 1 in both groups whereas it was insignificantly higher in high energy group than low energy group which after 8 weeks increased in both groups but remained elevated in high energy group than low energy group.

Conclusion

Serial monitoring of these physiological markers reflect the actual status of bone resorption, and bone formation respectively over a short period. Thus, they can be used as an adjunct to clinical and radiological evidence of fracture healing.
Early Complications of using Dual Mobility Cup in Total Hip Arthroplasty. A Systematic Review
Authors: Mahmoud Amr Khairy , Mansour Saleh Gameel , Anis Ibrahim Barsoum
Published: October 2021

Background

Total hip arthroplasty (THA) is considered one of the most successful surgical procedures providing pain relief and improvement of function in patients with end-stage hip arthritis that does not respond to non-operative treatments. As health care continues to improve and life expectancy increases, the demand for total joint replacement will grow to reflect this more active, aging population.

Objectives

This study aims to review early complications of dual mobility cup arthroplasty. The objective is to perform a systematic review of early complications of dual mobility cup arthroplasty for primary and revision cases.

Methodology

Types of studies we will include randomized control trails (RCTs), controlled clinical trials, retrospective cohort studies, and we will exclude case reports, case series studies, cross sectional studies, non English studies. Search results will be conducted to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be produced based on the search results and the inclusion/exclusion criteria. We will search the MED-LINE database, PubMed, Cochrane Bone and Muscle Trauma Group Specialized Register, Cochrane Register of Controlled Trails (The Cochrane Library) using the following keywords related to: THA, Dual mobility cup, complications, intraprosethetic dislocation.

Results

Early complication rate in dual mobility cups is significantly higher in revision cases compared to primary cases, with the exception of IPD which was significantly lower in revision cases. Early complication rate of conventional THA was significantly higher than both primary and revision dual mobility cups.

Conclusion

Dual mobility THAs are a good alternative to traditional bearing surfaces with long survivorship and low rates of instability after primary and revision THA. The rate of complications which are unique to the procedure, including intraprosthetic dislocation, is relatively low and limited mainly to earlier designs. High-quality, prospective, comparative studies are needed to further evaluate the use of dual mobility in primary and revision THA.
Arthrodesis of First Metatarsophalangeal Joint by Plate and Screws for Treatment of Hallux Rigidus (Systematic Review and Meta-Analysis)
Authors: Shazly Ossama Abdelraoof El , Abdellah Mohamed Mokhtar , Abouzaid Mostafa Abdelnabee
Published: October 2021

Background

With continued loss of dorsiflexion of the 1st MTP, degenerative changes occur within the joint with severe restriction of movement and increase in pain, which leads to the condition known as hallux rigidus. The amount of dorsiflexion may be reduced to 0-10 degrees with pain on both active and passive motion.

Objectives

Systematically reviewing available evidence from published articles to assess the effectiveness of arthrodesis of first metatarsophalangeal joint by plate and screws in hallux rigidus. The assessment also would encompass safety, side effects, and complications of this mode of treatment.

Materials and Methods

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

Results

Previous results for arthrodesis have been favourable with a union rate of almost 96%. In the present systematic review and meta-analysis, the overall effect estimates showed that the union rates after plate and screw arthrodesis for 1st MTPJ was 96.2% (95% CI 94 – 98.4%). In addition, the overall effect estimates showed that the non-union rates after plate and screw arthrodesis for 1st MTPJ was 4.2% (95% CI 2.4 – 6.1%). Moreover, the overall effect estimates showed that the satisfaction rates after plate and screw arthrodesis for 1st MTPJ was 94.5% (95% CI 90 – 99%). In the present study, the overall effect estimates showed that the overall complications rate after plate and screw arthrodesis for 1st MTPJ was 7.2% (95% CI 2.5 – 12%). The overall effect estimates showed that the malunion rates after plate and screw arthrodesis for 1st MTPJ was 2.7% (95% CI 0 – 6.4%). Additionally, the overall effect estimates showed that the hardware removal and superficial infection rates after plate and screw arthrodesis for 1st MTPJ were 2% and 2.9%, respectively.

Conclusion

Our analysis showed that plate and screws fixation is effective techniques that can be used for first MTPJ arthrodesis in patients with hallux rigidus. We found that the screw and plate fixation has a significantly lower rate of nonunion compared with the screw alone, as reported by the literature. However, owing to the small group sizes and methodologic shortcomings, we were unable to identify the clinically superior fixation technique for first MTPJ arthrodesis arthrodesis.
Surgical Modalities versus Conservative Treatment for Acute Injuries of Lateral Ligament of Ankle
Authors: Elbeltagy Atef Mohamed Fathy , Ashoub Mostafa Mamdouh Abdelrahman , Ahmed Shady Saleh Mohammed
Published: October 2021

Background

Acute ankle sprain is a very common injury which comprises 80% of all ankle injuries. Acute ankle sprain affects almost exclusively the lateral ligamentous complex including ATFL followed by CFL, while PTFL is rarely of clinical significance.

Objective

To study the clinical trials in a Meta-analytical form, in order to compare surgical versus conservative treatments for the management of acute injuries of the lateral ligament complex of the ankle.

Materials and Methods

We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analyses Of Observational Studies in Epidemiology (MOOSE) statements. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies.

Results

In the present study, we searched Medline via PubMed, SCOPUS, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) from their inception till April 2019. The search retrieved 702 unique records. We then retained 48 potentially eligible records for full-texts screening. Finally, 14 studies (Total No. of patients=1896) were included in the present systematic review and meta-analysis Conclusion: Starting a physiotherapy programme as early as possible is essential to control pain and swelling, to improve and maintain the range of motion, and to minimize the risk of stiffness and muscle wasting, which are the two decisive factors which delay patients from returning to their normal activities. Regardless of severity, surgery for acute ankle sprain is not recommended anymore.
Outcomes of Using Different Generations of Telescopic Intramedullary Nails in Lower Limbs in Management of Osteogenesis Imperfecta Patients. A Systematic Review
Authors: Ghaly Nabil AbdEl-Moneem , Ahmed Ahmed Rayan , Wafa Tarik Abdelrahman
Published: October 2021

Background

Osteogenesis imperfecta is a group of heterogeneous disorders with a common characteristic of congenital bone fragility caused by mutations in genes encoding procollagen type I. (COL1A1 and COL1A2).

Objectives

This study aims to review the outcomes of the use of different generations of telescopic intramedullary nails in lower limbs for management of children with osteogenesis imperfecta (OI) and evaluate the functional outcomes of them.

Patients and Methods

Methodology: Criteria for considering studies for this review, types of studies: we will include: case series studies, retrospective cohort studies and we will exclude: case reports, cross sectional studies, non English studies. Search results will be conducted to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be produced based on the search results and the inclusion/ exclusion criteria.

Results

One of the highest complications that have been very challenging for the orthopedic surgeons is migration and displacement of the telescopic intramedullary nails and FassierDuval nail has showed to have the lowest migration and displacement incidence rate (10.3%) which was clinically significant according to our statistics which supports the previous literature. On the other hand according to our statistics we found that there is no statistical significance in the cortical perforation of the telescopic nails between the different generations despite it might have been thought before that Bailey-Dubow nail has higher cortical perforation rate as the P value = 0.413. Post operative fractures and telescopic nail bending have shown no statistical significance according to our statistics which differ from each study when taken separately with P value = 0.252 and P value = 0.059 respectively. For the bending results we think that more studies are needed to increase the number of patients as it might show statistical significance according to its P value.

Conclusion

Fassier-Duval telescopic nail has good outcomes with the least complication rates and a promising generation of telescopic nail but needs a multicenter randomized control trials to conduct a level I evidence based on meta-analysis.
Validation of Bench Training Model for Cleft Palate Surgery
Authors: Masoud Karim Samir , Ghanem Mohamed Abdel Mohsen , Hweidi Ahmed Sobhi , Zidane Ahmed Mostafa El Sayed
Published: October 2021

Background

Cleft palate is one of the most common congenital malformations worldwide. It can be non-syndromic or it can appear as a part of a syndrome or recurrence pattern.

Aim of the Work

To provide a valid life-size realistic training model of cleft palate surgery that aids in pre-operative training of residents and improvement of their skills in life surgery.

Patients and Methods

This interventional pilot study was done after approval of institutional ethics committee in Ain Shams University Hospitals operating theatres and in plastic surgery department’s skill lab for 6 months and obtaining an informed written consent from parents. It was designed to develop a bench model of cleft palate for pre-operative training of surgeons and assess its validity.

Results

In our study we found that the performance of trainees after using our developed bench model of cleft palate shows statistically significant improvement according to GRITS score by 63.2% compared to those who proceeded to live cases directly without training

Conclusion

This study further demonstrates the effective use of a novel cleft palate bench model as a training tool. After a single session, we observed improvement in cleft palate procedural skills, confidence, knowledge and time taken to finish the operation among trainees both with and without previous cleft experience. Additional research is needed to assess the durability of these improvements over time, and also the benefit of additional sessions with the bench model.