bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk of Suicide in a Sample of Egyptian Male Patients with Substance Use Disorder during Covid-19 Pandemic
Authors: El Masry Shereen Hatem Anwar , Okasha Tarek Ahmed , Abd Elazziz Mohamed Fekry , Naguib Rehab Mohamed , Tawfik Fairouz Ahmed
Published: November 2024

Background

Suicide is a global burden among the leading causes of death.

Aim of the Work

This study aimed to investigate the suicide risk in male substance abuse patients during the COVID-19 pandemic.

Patients and Methods

This study is a Cross-sectional descriptive study was approved by the ethical committee of the Department of Neuropsychiatry, Faculty of Medicine, Ain Shams University, conducted at Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University Hospitals which is located in Cairo and serves a catchment area of about the third of Greater Cairo. It serves both urban and rural areas, including areas around Greater Cairo as well.

Results

Personality disorders, borderline personality disorder, and antisocial personality disorder were significantly associated with death wish, ideation, and suicide attempts. Individuals with polysubstance were more likely to have suicidal thoughts and behaviors. Family history of addiction was significantly associated with increased suicide risk.

Conclusion

It is important to underscore the importance of comprehensive assessment, early intervention, and ongoing support to mitigate this risk and promote long-term recovery and well-being.
Burnout Syndrome among Family Caregivers of Hemodialysis Patients in Luxor International Hospital
Authors: Mohamed Wael Alraey , Hosam Mohamed , Mohamed Mariam Yehia , Sayed Maha Mohamed
Published: November 2024

Background

Chronic illness caregivers experience sadness, anxiety, drug usage, physical deterioration, and poor quality of life. Burnout from lack of support affects family, professional, and social life. Hemodialysis stresses caregivers, who stop work for long-term care. Burnout is caused by long hours, interpersonal challenges, and unpredictability. Chronic stress may impact quality of life with physical and mental symptoms.

Aim

To assess burnout in hemodialysis family caregivers, factors contributing, including sociodemographics, job aspects, and burnout's impact on their quality of life.

Methods

This cross-sectional study at Luxor International Hospital, starting January 2023, includes 100 participants, caregivers, and healthy individuals linked to regular hemodialysis patients. Participants will complete a questionnaire covering sociodemographic information and four validated measures assessing burnout, stress, mental health, and quality of life. Interviews with family caregivers will collect further data and include these questionnaires (CBI, PSS- 10,GHQ-28,WHOQOL Bref).

Results

The average age of research participants is 42.39. Based on CBI ratings, 78% have little personal burnout. Age affects burnout and mental health. Personal burnout is gendered. Burnout and mental anguish are linked to work hours. Marital status affects psychology. Education affects burnout and life quality. Parenthood influences mental health. Smoking connects with subjective stress but not others.

Conclusion

The study reveals significant burnout, perceived stress, and psychological distress among hemodialysis caregivers. Despite low burnout in most, substantial psychological distress is evident, affecting their quality of life. Factors like age, gender, marital status, education, children, and smoking influence caregiver experiences.
Outcomes after Deep Brain Stimulation for Generalized Dystonia
Authors: Zoghdan Hassan El-Sayed Hassan , Salem Tarek Mohamed Lotfy , Abouelela Abdelmawla Radwan Hesham Mohamed , Youssef El-Mashad Mohamed Gamal
Published: November 2024

Background

Deep Brain Stimulation (DBS) is an already established treatment option for refractory dystonia. Its main targets are currently the globus pallidus internus (GPi) and the subthalamic nucleus (STN) with similar motor and disability outcomes, 50 to 70% in isolated generalized/segmental inherited/idiopathic dystonia. This systematic review and meta- analysis aimed to assess the efficacy outcomes of DBS use in patients with generalized dystonia.

Methods

This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the searched strategy was developed using the Mesh Database to find the similar keywords to the main keywords in our study. We searched PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar for eligible articles to be included in our study using the following search strategy: (Brain Stimulations OR Deep Brain Stimulations OR Brain Stimulation OR Deep Brain Stimulation OR Electrical Stimulation of the Brain) AND (movement disorders OR dystonia syndromes OR dystonia).

Results

A total of 25 articles were included in our meta-analysis. The pooled analysis of 25 studies showed the improvement in the BFMDRS-movement score after deep brain stimulation as evident by the decrease in the pos-DBS values with an overall mean difference of -25.96 (95%CI: -29.24 - -22.69, p < 0.00001) with moderate heterogeneity (I2=51%, p = 0.002). Regarding BFMDRS-disability score, it was statistically significant reduced after deep brain stimulation compared to pre-operative values with an overall mean difference of -5.69 (95%CI: -7.04 - -4.35, p < 0.00001) and moderate heterogeneity (I2=50%, p = 0.02).

Conclusion

Our study demonstrated the deep brain stimulation's excellent efficacy across various parameters. This included mobility and disability on the BFMDRS, while the use of DBS is linked to improved post-operative results when compared to pre-operative values. Furthermore, according to the SF-36, which measures both mental and physical performance, DBS has demonstrated a high efficacy on quality of life. Furthermore, DBS was linked to a considerable decline in depressed symptoms, as demonstrated by the BDI score, which dropped dramatically in individuals with generalized dystonia following DBS application.
Safety and Efficacy in Treatment of Ruptured Small Anterior Circulation Aneurysms
Authors: Saleh Mamdouh Shaaban , El-Hussiney El-Hussam , Habib Mohammed Alaa Aldien , Tobar Ahmed Faisal , El-Sayed Ahmed
Published: November 2024

Background

Small aneurysms ≤10 mm in diameter account for almost 6% of all ruptured intracranial aneurysms and pose a therapeutic dilemma for the treating physician. Published studies have investigated the safety and efficacy of endovascular therapy unilaterally without comparison to a surgical group, which limits the value of their findings

Objective

To review of literature and recent publications regarding treatment of the small anterior circulation aneurysms, evaluate the outcome of treatment of small anterior circulation aneurysms in Ain Shams University Hospitals, determine the incidence of various complications, define the good and bad prognostic criteria for outcome and to compare between the variable modalities of treatment of anterior circulation aneurysms

Methods

This prospective study was done in the Neurosurgery Department in Ain Shams University hospital, on 30 patients admitted to the Emergency Unit of Neurosurgery suffering from spontaneous subarachnoid hemorrhage (SAH) due to ruptured small anterior circulation aneurysm.

Results

There was no statistically significant difference found between clipping group and coiling group regarding age, sex, aneurismal size, Hunt & Hess grade and Fisher grading. Also, there was no statistically significant difference found between clipping group and coiling group regarding percentage of complications during procedure. There was no statistically significant difference found between clipping group and coiling group regarding percentage of complications post procedure except pneumocephalus was found with higher percentage in clipping group (33.3%) than coiling group (0.0%) with p-value = 0.014. There was no statistically significant difference found between clipping group and coiling group regarding modified Rankin Scale with p-value = 0.440

Conclusion

Lower procedural complication rates were seen with endovascular therapy as compared to open surgery in small ruptured aneurysm. Overall patient outcomes, however, were similar in both groups. In light of our results, endovascular treatment of small ruptured aneurysm seems to be feasible, safe, and effective and might be a preferred option in this setting. These data provide impetus for further study, in which small ruptured aneurysm need not be excluded from comparisons of coiling and neurosurgical clipping. More specifically, the stage is set for a randomized controlled trial to compare the 2 treatment modalities in patients with small ruptured aneurysm.
A Systematic Review of Comparison of Early Surgical Intervention versus Followup in Management of Adult-Type Diffuse Low Grade Gliomas with No Motor Neurological Deficit in Terms of Survival Rate and Quality of Life: A Systematic Review
Authors: Moustafa Hazem Ahmad , Hamada Salah Moustafa , El-Sabaa Ahmad Mohammed , Khater Omar Ahmad
Published: November 2024

Background

The precise optimal management of patients with low-grade glioma remains to be determined. Active surveillance, needle or open biopsy, as well as surgical resection have all been advocated by different authors. Surgical resection is superior when compared with observation to improve overall survival for patients with LGG (Level III) although observation has no negative impact on cognitive performance and quality of life (Level II).

Objective

To systematically review the available literature discussing the outcome of early resection versus followup on overall survival and quality of life of such patients. With evaluation of the impact of extent of resection on overall survival and the value of utilizing preoperative and intraoperative technical aids (imaging and mapping) on the postoperative functional outcome.

Patients and Methods

Systematic review of published English literature from Jan. 2000 to Jan. 2024.

Results

A total of 10955 citations were retrieved according to our search strategy and review of bibliographies. 10 of these studies met the inclusion criteria and were included in the analysis, 7 were before 2021, 3 were after 2021. They were obtained from Medline via PubMed.

Conclusion

DLGGs management is multimodal and involving the interplay of the treatment modalities. The determination of an optimal treatment plan for a DLGGs patient should be individualized based on the patient’s age, sex, location of tumor, molecular status, and co- morbidities. Besides, putting into consideration the timing (early vs. delayed) of treatment as well as the positive and negative impacts of treatment on survival, quality of life, and seizures control. However, it’s clear that the introduction of the new technical aids, has improved all the outcomes of the surgical resection, rendering it the superior option of the two at the current time.
Anterior Cervical Discectomy and Fusion with and without Plating versus Laminectomy with and without Fusion for Multilevel Cervical Spondylotic Myelopathy: A Comparative Study
Authors: Badr Ashour Wael Mamdouh , Ibraheem Hemeeda Salah Abdel-Khalek , Abdel-Khalek Elserry Tarek Hamdy , Ahmed Ibraheem Omar Elfarok , Mohamed Hisham Elgayaar Abdel-Rahman
Published: November 2024

Background

Cervical spodylotic myelopathy (CSM) is a chronic progressive spinal compression that usually accompanies age-related degeneration of the cervical spine and represents one of the most common causes of spinal cord dysfunction. Surgical intervention is the foundation of management in symptomatic cases, but the approach of choice is constantly contentious.

Purpose

The aim of this study is to evaluate and appraise different surgical approaches for multilevel cervical spondylotic myelopathy (Anterior cervical discectomy and fusion with or without plating and Laminectomy with and without fusion) regarding the perioperative data, clinical outcomes, complications rates and radiographic parameters.

Patients and Methods

This work is a prospective comparative study of 80 patients assigned into four groups. The first group (n = 20) underwent ACDF only, the second group (n = 20) underwent ACDF with anterior plate, the third group (n = 20) underwent laminectomy alone and the fourth group (n = 20) underwent laminectomy with lateral mass fusion. Patients were followed up for 12 months duration using modified Japanese orthopedic score (mJAO), Neck disability index (NDI), Visual analogue scale (VAS) and short form 36 (SF-36) in addition to measurement of C2-C7 cobb`s angle to evaluate post-operative cervical sagittal alignment.

Results

Our results revealed that all the four surgical techniques were associated with functional improvement compared to preoperative parameters. Anterior approaches were associated with better restoration of lordosis and better overall quality of life than posterior approaches.

Recommendations

We recommend designing randomized controlled trials in the future with longer follow-up periods to address long-term outcomes and/or complications.
Diagnostic Accuracy of Tomographic Ultrasound Imaging (TUI) in Depth of Myometrial Invasion and Cervical Stromal Invasion in Endometrial Carcinoma
Authors: Faisal Malames Mahmoud , Ahmed Abdelhamid Sherief Mohamed , Farid Laila Aly , Mohamed Ahmed Saleh Elnabeshy
Published: November 2024

Background

Endometrial cancer (EC) is the most common gynecological neoplasm Of female genital organ in developed countries accounting for 50% of all gynecological cancer. The imaging routine in preoperative assessment of EC differs amongst the gynecologists. The advantages of cross-sectional imaging are taken for granted in computed tomography and magnetic resonance imaging. Recently, tomographic ultrasound has introduced these advantages to sonographic volume imaging.

Aim of the Work

To evaluate the potential accuracy of 3D tomographic ultrasound imaging (TUI) coupled with power Doppler in comparison to computed tomography scan in the detection of depth of myometrial invasion and stromal invasion in endometrial cancer in relation to histopathology.

Patients and Methods

This cross-sectional study (Diagnostic purpose) included fifty biopsied women who are pathologically proven endometrial cancer for two years (December 2018- December 2020). This study conducted at Ain Shams university Maternity Hospital (Gynecology oncology unit)

Results

This study showed that 2D US (Invasion ≥50.0%), Doppler (Feeding vessel), TUI (Coherent vessels), TUI (Margin disruption) and CT (Invasion ≥50.0%) were significantly more frequent in cases with positive cervical stroma invasion. There was no statistical significant difference according to endometrium invasion (histopathology) regarding demographic characteristics and clinical presentation.

Conclusion

Endometrial cancer (EC) is the most common gynecological neoplasm of female genital organ in developed countries accounting for 50% of all gynecological cancer. 3D tomographic ultrasound imaging (TUI) coupled with power Doppler showing significant accuracy in the detection of depth of myometrial invasion and stromal invasion in endometrial cancer in relation to histopathology.
Magnetic Resonance Imaging MRI versus Color Doppler Ultrasound for Assessment of Placenta Accreta Spectrum Disorders
Authors: Ismail Abdel Megeed Abdel Megeed , El Sherbeny Mohammed Mahmoud , Abdelnasser Ahmed Gamal , Mohamed Aya Attia Mohamed
Published: November 2024

Background

As placenta previa and placenta accreta are the two most common causes of postpartum hemorrhage, early and accurate diagnosis, preoperative assessment, and intraoperative management are crucial for a successful outcome. However, risk assessment of intraoperative massive hemorrhage in patients with placenta previa and accreta is challenging in clinical practice.

Aim of the Work

To compare the sensitivity and accuracy of MRI versus color Doppler US in the diagnosis of morbidly adherent placenta in women with placenta previa accreta spectrum.

Subjects and Methods

This was a cohort prospective study was done in cases was recruited from the pregnant women attending outpatient clinic or emergency department at Ain Shams University Maternity Hospital. The study was include 62 pregnant women.

Results

The final US results shows that from the 90 studied patients; 25 patients have no presence of accreta (37.8%) and 65 patients have presence of accreta (72.2%). The final MRI results shows that from the 90 studied patients; 35 patients have no presence of accreta (38.9%) and 55 patients have presence of accreta (61.1%). there was statistically significant increase in the percentage of patients with history of thyroidectomy and IUD removal laparoscopic in patients with placenta accreta (7.5% and 7.5%; respectively) than patients without placenta accreta (0.0% and 0.0%; respectively) with p-value = 0.049 and 0.049; respectively. there was statistically significant increase in the percentage of accuracy of MRI results (73.3%) than ultrasound results (58.9%).

Conclusion

Regarding to our results we concluded that ultrasound can detect patients with placenta accreta with sensitivity of 92.5%, specificity of 32.0% and overall accuracy of 58.9% while MRI can detect patients with placenta accreta with sensitivity of 100.0%, specificity of 52.0% and overall accuracy of 73.3%, there was statistically significant increase in the percentage of accuracy of MRI results (73.3%) than ultrasound results (58.9%) with p-value <0.001.
Pain Scoring in Uterine Evacuation for Incomplete Abortion Using Isolated Paracervical Block vs Combined Paracervical and Intrauterine Lignocaine Instillation: A Randomized Clinical Trial
Authors: ElRabat Mohab Ahmed Fouad , Sammour Hazem Mohamed , Sweed Mohamed Samir , ELsersi Mayar Hassan , Oraby Aya Sameh AbdelRazek , Eltaieb E
Published: November 2024

Background

Nerve block is a technique whereby local anesthetic solutions are infiltrated around a nerve (or perineurally) to provide anesthesia and analgesia. Nerve block for intraoperative and postoperative pain management is associated with improved analgesia, fewer opioid-related adverse events, earlier ambulation and shorter hospital stay when compared to intravenous opioid analgesia alone.

Objective

To compare efficacy of paracervical block alone versus combined paracervical block and intrauterine lidocaine installation in pain management of first trimesteric incomplete abortion.

Patients and Methods

A total of 80 women with first trimesteric incomplete miscarriage were admitted to the emergency department for uterine evacuation at Ain Shams University Maternity Hospital, in the period from September 2021 to September 2023 and underwent uterine evacuation using either paracervical block or combined paracervical block and intrauterine lidocaine instillation then pain score was obtained using visual analogue scale. Pain score was done 10 minutes after injection of local anaesthetic, 5 minutes after starting procedure and 1 hour postevacuation.

Results

It also showed that there was no statistically significant difference between both groups regarding need of opioids and time interval till opioids need. Exploring other factors that might have affected the success or failure of procedure in the study population it was found that age, parity were significant predictors such that the younger the age, the less the parity the more likely failure of procedure. Also being previous section was linked more to success than failure.

Conclusion

The combination of intrauterine lidocaine and paracervical block has no additive effect on conventional paracervical block in reducing the pain during uterine evacuation for incomplete abortion, but successful evacuation resulted in lower pain score and reduced needs for opioid.
Evaluation of El-Demerdash Maternity Hospital Experience in Management of Pregnant Women Diagnosed with Placenta Previa
Authors: Mohamed Hend A , Hassanin Alaa S , El Safty Mohammed S , Elshahawy Hazim F
Published: November 2024

Background

Placenta previa is a potentially dangerous condition that can affect pregnant women, leading to significant maternal morbidity and adverse perinatal outcomes.

Aim of the Work

Evaluation of placenta previa management, study of maternal and perinatal outcomes in cases of placenta previa, and study of risk factors for placenta previa.

Patients and Methods

The study included 80 women with placenta previa who were diagnosed and managed at El-Demerdash Maternity Hospital.

Results

The sociodemographic characteristics of the included patients showed a preponderance of the ages above 30 years, multiparity, history of previous cesarean section, and history of uterine scarring. Maternal outcomes showed a reasonable decrease in the hemoglobin level postoperatively compared with preoperatively. However, there was a high incidence of blood transfusion. There was an overabundance of general anesthesia performance during surgical intervention. The majority of the placenta previa patients had cesarean delivery; however, there was a low incidence of maternal surgical injuries and mortality. Regarding neonatal outcomes, most of the neonates belonged to the preterm group. The neonatal intensive care unit (NICU) admission was reported in nearly half of the included patients, attributed to preterm, respiratory distress (RD), and intrauterine growth restriction (IUGR). There was a low incidence of perinatal mortality.

Conclusion

In El-Demerdash Maternity Hospital, risk factors for placenta previa were age above 30 years, multiparity, history of previous cesarean section, and history of uterine scarring. Most placenta previa patients received conservative surgical management rather than cesarean hysterectomy. Despite the higher rate of conservative surgical management compared to cesarean hysterectomy, maternal surgical morbidity and mortality were low. However, there was a higher frequency of blood transfusion to manage postpartum hemorrhage. Most of the neonates were preterm, and neonatal intensive care unit admission was reported in nearly half of the included patients. There was a low incidence of perinatal mortality.
A Retrospective Analysis of Epidemiology and Clinical Outcomes of Patients with Epithelial Ovarian Tumors Treated in Ain Shams Clinical Oncology Department in the Period from 2017 Till 2020. Ain Shams Clinical Oncology Registry (ASCOR)
Authors: Ahmed Nahla Hamdy El Sayed , Azmi Ali Mohamed , Mosalam Nesreen Ahmed , Farag EL Ghamry Wessam Reda , El Aziz Ahmed Hassan Abd , Wahba Christine Reda
Published: November 2024

Background

OC is the 3rd most commonly diagnosed gynecological malignancy and ranked 2nd most common cause of gynecological malignancies deaths. In our study we reviewed medical records of 97 patients including demographic data and clinico-pathological factors; which include age, performance status, histological subtypes, histological grading, optimal surgery, CA 125 level at presentation and relation with macroscopic residual, number, types, setting and lines of chemotherapy, survival rates were calculated to evaluate them as prognostic factors.

Aim of the Work

to analyze Retrospectively Epidemiological, Risk factors and Clinical Outcomes of Epithelial Ovarian Cancer Patients Treated in Ain Shams University Hospitals in Egypt in the Period From 2017 till 2020.

Patients and Methods

At the department of clinical oncology and nuclear medicine, Ain Shams University teaching hospitals, patients with a histologically confirmed diagnosis of epithelial ovarian cancer, in the period from January 2017 to December 2020, were included in this retrospective analysis.

Results

Our results showed that ECOG status had a statistically significant correlation with OS and PFS, the better the performance the longer the OS and PFS (p = 0.000, 0.000 respectively). Our study population showed similar results were Platinum sensitive patients showed strong correlation to PFS & OS period with the best in the group platinum sensitive and minimum difference in groups showed no response to platinum or were resistant (p value = 0.000).

Conclusion

our study shows prognostic effects for age, performance status, histological grade, stage, optimal surgery, number of chemotherapy cycles, and platinum sensitivity furthermore after adjustment for different cofounder, high score of age adjusted charleson index >2, stage, ECOG status, platinum sensitivity and optimal cytoreduction were independent prognostic factors affecting OS.
Quality of Life of Prostate Cancer Patients Treated with Androgen Deprivation Therapy in Ain Shams University Hospital
Authors: Mohamed Nora Sayed Mohamed , Ghali Ramy Refaat Youssef , Mosalam Nesreen Ahmed , El Ghamry Wesam Reda Farag , Soliman Mohamed Hassan Ali
Published: November 2024

Background

Prostate cancer is the second most common cancer in men worldwide, according to data from the World Health Organization (WHO) GLOBOCAN Database. The current lifetime risk of prostate cancer for men living in the United States is estimated to be approximately one in eight. In Egypt according to GLOBOCAN number of new cases of prostate cancer 4767 (7.2%), while 5-syear survival 97.5%.

Aim of the Work

In this study, we aimed to evaluate the impact of treatment with Androgen Deprivation Therapy on quality of life for prostate cancer patient treated in Ain Shams University Hospital using a questionnaire from European organization of research and treatment -quality of life for cancer patient – prostate (PR 25) on prostate patient an Arabic index validated.

Patients and Methods

This Cross-sectional study was conducted at tertiary care hospital at Ain Shams University hospitals from August 2022 to February 2023 and performed on a total of 45 prostate cancer patients who attended the outpatient clinic at oncology department at Ain Shams University for hormonal therapy that were diagnosed before 2021.

Results

Our study results revealed that there was no statistically significant correlation between the quality-of-life (QOL) scores and both age of patient and duration of hormonal treatment. In correlation with the demographic characteristics, our study results revealed that the symptom scale score and Functional scale score showed no statistically significant differences with the medical, surgical history of the patient, history of chemotherapy and radiotherapy, ECOG and Metastasis.

Conclusion

The quality-of-life scores (QLQ-PR25) revealed that the mean symptom scale was 41.11 (SD ± 10.94) and the functional scale was 67.22 (SD ± 13.86) with no significant correlation with both age of patient and duration of hormonal treatment. However, the study was single arm and lack the control group which may underestimate the sexual and urinary changes or outcomes due to the intervention by ADT in patients with prostate cancer. Consequently, the present study can burden the knowledge and shed some light on future prospective studies with larger sample sizes and control group demonstrating the long-term outcomes of ADT in patients with prostate cancer regarding the HR-QOL.
The Impact of the HER2 Status(HER2 Low vs HER2 Negative) on the Pathological Response to Neoadjuvant Chemotherapy in Hormonal Receptor Positive Breast Cancer
Authors: Mohamed Nourhan Saeed Abdel-Aziz , El-Leithy Mahmoud Mahmoud Abbas , Helal Thanaa Elsayed Ahmed , Mostafa Mohamed Yassin , Abdel-Aziz Ahmed Hassan , Elghazawy Hagar Ibrahim
Published: November 2024

Background

More than 50% of breast cancers are currently defined as “Human epidermal growth factor receptor 2 (HER2) low breast cancer (BC)”. Nevertheless, little is known about the response and prognosis of HER2-low BC receiving neoadjuvant chemotherapy (NACT).

Aim of the Work

The purpose of our study is to evaluate the impact of HER2status (HER2 low vs zero) on the response to neoadjuvant chemotherapy (NACT) in HER2− BC.

Patients and Methods

This study is a retrospective study that included 96 patients attending the breast clinic at the Clinical Oncology Department, Ain Shams University during the period from 1 January 2020 till 31 December 2022.

Results

A total of 96 patients were included, of whom 68.8% were HER2 0, where HER2 low was represented by 31.2 % of the patients. HER2 low had similar pCR rates in comparison to HER2 0 (13.3% vs 18.2%, P = 0.55). Ki67 is highly significant correlated with pCR, as in patients who achieved pCR, Ki67 percent was of median 35%, while Ki67 was of median 20% in patients who didn’t achieve pCR (P < 0.01).

Conclusion

HER2-low status appears to be associated with a similar pCR rate as HER2-0 in HR positive BC patients.
Retrospective Analysis of Outcomes and Toxicity of Adjuvant Imatinib in Patients with Gastrointestinal Stromal Tumor in Clinical Oncology Department in Ain Shams University
Authors: Abel-salam Riham Essam , Abdel-hakeem Khaled Naguib , Kamel Tarek Hussein , Bayomi Waleed Abdel-moniem , El-din El -Ghoneimy Khaled Kamal , Ahmed Sherief Hassanin
Published: November 2024

Background

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal (GI) tract. Most of them (>75%) are driven by an oncogenic initiating event involving activating mutations of the genes encoding for tyrosine kinase, KIT or platelet derived growth factor receptor alpha (PDGFRA). Efficacy of the tyrosine kinase Inhibitor imatinib is now well established for localized and advanced disease. For localized GISTs, 3 years treatment is the recommended adjuvant therapy for high risk patients. This review aims to describe current knowledge on the issue of adjuvant therapy of primary GISTs in view of available results and to further refine the definition of the population of GIST patients at high risk of relapse including molecular criteria

Aim of the Work

The purpose of this study is to retrospectively analyze the outcomes and toxicity of adjuvant Imatinib in patients with gastrointestinal stromal tumor

Patients and Methods

This study is a retrospective study that included 40 patients attending the sarcoma clinic at the Clinical Oncology Department, Ain Shams University during the period from 1 January 2016 till 31 December 2022.

Results

A total of 40 patients were included. Of whom 47.5% of patients completed 3 year duration of treatment by Imatinib, whereas those who didn't complete their 3 years treatment were presented by 52.5%. Higher DFS was found in those who completed their treatment duration in comparison to the second group with median DFS 67.8 vs 47.9 months respectively P value <0.003 highly significant. Imatinib was generally tolerated and toxicity was reported only in 20% of the study population, and the commonly found side effect was skin rash, followed by hematological toxicities then GIT manifestations. 22.5% of patients developed recurrence of the disease and higher rate of recurrence was found among elderly>60 years, tumor size>10 cm, and higher Ki67.

Conclusion

treatment with adjuvant Imatinib appears to be associated with higher DFS and we'll tolerated side effects
Role of Anterior Segment Optical Coherence Tomography in Evaluation of the Actual Depth versus the Planned Depth of Implanted Intrastromal Corneal Ring Segments in Treatment of Keratoconus
Authors: Oteifa Ahmed Magdy , Metwally Mohamed Gamil , Badran Tamer Abdel Fattah , Tawfik Caroline Atef
Published: November 2024

Background

Keratoconus is a non-inflammatory, progressive and usually bilateral corneal disease characterized by progressive corneal stromal thinning and abnormal corneal steepening causing visual deterioration. ICRS implantation is a safe and reversible procedure that can be used in treatment of keratoconus. The correct position and depth of the ICRS after implantation are crucial to avoid post-operative complications and to improve visual outcomes.

Objective

To compare the actual depth of implanted ICRS with the planned depth using AS-OCT one week, one month and three months post-operatively for better predicting of the visual and refractive outcomes as well as to aid in prevention and early detection of post-operative complications in keratoconic patients undergoing ICRS implantation.

Patients and Methods

A prospective observational uncontrolled case-series study that was done on 10 eyes of 10 patients aiming to compare the actual depth of implanted ICRS (Kerarings) with the planned depth using AS-OCT which took place in Ain Shams University Specialized Hospital and Eye Subspecialty Hospital, Cairo, Egypt.

Results

All implanted ICRSs in all treated eyes showed shallower depth of implantation when compared to the planned depth in the follow up periods. Results have shown that the average measured depth of the ring segments in relation to the corneal thickness was found to be 65.7 % ± 1.7% (range= 63.1% – 68.1%) after 1 week, 67.6% ± 2.2% (range= 63.6% – 70.5%) after 1 month and 66.8% ± 2.2% (range= 63.8% – 70.6%) after 3 months. When comparing the actual depth of implantation to the thinnest pachymetry measured preoperatively, results have shown that the actual depth was found to be 64.6% ± 2.3% (range= 61.1% – 69.1%) after 1 week, 67.0% ± 4.3% (range= 60.8% – 74.9%) after 1 month and 65.3% ± 3.3% (range= 60.2% – 71.1%) after 3 months instead of the planned 80%.

Conclusion

ICRS are implanted at a shallower depth than intended. Stromal compression might have played a role in corneal stromal thinning above the implant and thus causing a false shallower depth of implantation. This can be further studied by implementing a confocal microscopy on larger sample sizes to be able to document actual anterior stromal collagen lamellae compression.
Ocular and Systemic Effects of Intravitreal Dexamethasone Sustained Release Implant in Refractory Diabetic Macular Edema
Authors: Ibrahim Ahmed Mohamed Ahmed , Kabeel Mamdouh Mahmoud , Elbayoumi Boshra Mohamed Ali , Elshormilisy Amr Aly Mohamed , Montaser Ahmed Samir
Published: November 2024

Purpose

Intravitreal therapies with anti-VEGF medications are regarded as effective treatment option. The biodegradable intravitreal implant, Ozurdex (Allergan, Irvine, CA, USA) depends on slow-release dexamethasone. The present study aimed to assess the safety of intravitreal Ozurdex in patients with refractory DME.

Methods

This prospective study included patient with resistant DME who received intravitreal Ozurdex. baseline clinical evaluation, change in best corrected visual acuity BCVA and central retinal thickness CRT were analysed, intra ocular pressure, HbA1c, adverse effects were recorded.

Results

The reported CRT measurements showed significant decrease in the first 3 months post injection. The reported BCV showing significant improvement from the baseline values, there was significant increase in IOP in the first month only which was controlled with medical treatment, with no influence on HbA1c.

Conclusions

for patients with refractory macular oedema, Ozudex implant showed improvement in visual acuity and decreased macular thickness and there was no influence on metabolic control, side effects such as increase of intraocular pressure may require medical treatment.
Comparison between Goldmann Applanation Tonometry and Air Puff Tonometry for Measurement of Intraocular Pressure in Siliconized Eyes
Authors: Samady Hossam Maged Mohamed El , El-Ibiary Hany Mohamed , El Yasser Abd , Zankalony Maguid El , Ali Kandil Haytham Mohamed
Published: November 2024

Background

Silicone oil (SO) has been a part of vitreoretinal surgery since the 1960s. The use of silicone oil in conjunction with advanced vitreous surgical techniques can successfully treat complicated retinal detachment (RD).

Aim of the Work

to compare the intraocular pressure (IOP) measurements following Pars Plana Vitrectomy (PPV) with injection of Silicone Oil (SO) by Goldmann applanation tonometry (GAT) and noncontact Air Puff Tonometer (APT).

Patients and Methods

This study included a total of 165 eyes of 165 patients. Of these 165 patients, 110 have undergone PPV and silicone oil injection, while the remaining 55 participants served as the control group.

Results

The participants in our study were divided into a control group, and a siliconized group which was subdivided into SO 1000 cSt (Group A) and SO 5000 cSt (Group B). The control group had an average age of 50.65±12.26 years, Group A had an average age of 53.53±12.04 years, and Group B had an average age of 55.45±12.02 years. The control group in our study consisted of 28 males (50.9%) and 27 females (49.1%), while Group A had 37 males (67.3%) and 18 females (32.7%), and Group B had 38 males (69.1%) and 17 females (30.9%). Central corneal thickness (CCT) was measured for all participants. The average CCT was 536.53±28.66µm for the control group, 531.67±29.19µm for Group A, and 527.13±28.79µm for Group B. There was no statistically significant difference in the CCT measurements between the study groups (P = 0.410). The average IOP values were obtained using both the airpuff tonometer (APT) and Goldmann applanation tonometry (GAT) methods. In the control group, the average IOP was 16.56±2.98 mmHg using APT and 15.27±2.73 mmHg using GAT. For Group A, the average IOP was 17.09±7.0 mmHg with APT and 15.61±6.43 mmHg with GAT. In Group B, the average IOP was 16.71±4.93 mmHg using APT and 15.13±4.63 mmHg using GAT. The P-value was >0.05 in all groups, indicating that the differences were not statistically significant.

Conclusion

the results showed a correspondence between the Goldmann applanation tonometer (GAT) and the airpuff tonometer (APT) in siliconized eyes. The differences in intraocular pressure (IOP) measurements between the two instruments were minimal and not statistically significant, with APT measurements being slightly higher than GAT measurements. The study also concluded that there is a greater chance of increased IOP following pars plana vitrectomy (PPV) and silicone oil (SO) injection with SO 1000 cSt compared to 5000 cSt, but this difference was not statistically significant. Furthermore, this IOP difference between the two methods was not correlated with age, gender, CCT, or lens status of the patients. Thus, there is good agreement between the two methods.
Incidence of Persistent Avascular Retina Post Intravitreal Injection of Ranibizumab for Retinopathy of Prematurity
Authors: Labeeb Jacklin Henry Thabet , Ziko Osman , Al-Feky Mariam
Published: November 2024

Background

Retinopathy of prematurity (ROP) is a vision threatening retinal disease caused by vascular proliferation in the immature retina of premature infants, the lower the gestational age and birth weight, the higher the chance of developing ROP.

Aim of the Work

Our study discuss the incidence of PAR after 6 months of follow up and the recurrence rate of retinopathy of prematurity (ROP) after treatment with intravitreal injection of ranibizumab.

Patients and Methods

25 eyes of 13 patients with type 1 ROP and AROP underwent intravitreal injection of ranibizumab as an initial treatment between October 2021 and November 2022 were included in this study.

Results

Data of patients included GA, BW, age at initial injection (weeks), type of ROP, the recurrence rate of ROP and number of injections needed, incidence of PAR and if complete retinal vascularization occurred, the age at complete retinal vascularization (weeks) were analyzed, if FFA was done to assess leakage in areas of PAR and laser was done to the area of PAR. 11 eyes (44%) of the studied eyes had near complete vascularization at PMA of 45-66 weeks, and the remaining 14 eyes(56%) had PAR after 6 months of follow up after IVR injection. Recurrence occurred in three eyes (12%), one eye of them was injected twice and two eyes had three injections.

Conclusion

Screening for ROP should be taken seriously and should include all infants at risk of developing ROP to avoid visual complications. Recently the use of intravitreal injection of ranibizumab is effective in treating advanced ROP. The treatment with IVR lead to complete retinal vascularization at PMA 45-66 weeks. In case of PAR, FFA may be useful before applying laser to detect any vascular leakage in this avascular retina. Recurrence of ROP can occur during a period of 5-7 weeks after IVR injection, so long term follow up should be done for proper observation and management of any recurrence.
Comparative Study Evaluating the Post Phacoemulsification Refractive Predictive Accuracy Using Sirius+ Scheimpflug Tomography and Nidek Optical Biometer AL-Scan
Authors: Wessam Moataz Mohammed , Salman Abdel Rahman Gaber , El Din Zaki Rania Gamal , Ahmed Marwa Abd el Hamid Hassan
Published: November 2024

Background

IOL power calculation is now a crucial step in cataract surgeries especially after development of phacoemulsification and intraocular lens as the aim of cataract surgery now is no longer media opacity treatment only but also correction of refraction errors. That’s why new devices with new techniques as Sirius Scheimpflung tomography which combines both Scheimpflug camera and placido disk corneal topography and uses ray tracing method and artificial intelligence in IOL power calculation was evolved to increase the accuracy of IOL power calculation.

Purpose

Compare the accuracy of predictability of postoperative refraction of Sirius + (CSO, Italy) Scheimpflung tomography with Nidek optical biometer AL-scan (Nidek CO., Tokyo, Japan).

Materials and Methods

Forty eyes of twenty eight patients were enrolled in this prospective cohort comparative study, which was performed at the Department of Ophthalmology of Ain Shams University Hospitals during the period between April 2023 till December 2023. The patients underwent complete ophthalmological examination and did biometry with both Sirius tomography and Nidek optical biometer, then postoperative refraction was done using autoref (Shin-Nippon accuref 8001, Japan. Comparison between predicted refraction by Sirius and Nidek with postoperative refraction was done.

Results

There was statistically significant difference between the Nidek postoperative predictive refraction and the postoperative spherical equivalent of the studied patients with p-value < 0.05, while there was statistically non-significant difference between the Sirius postoperative predictive refraction and the postoperative spherical equivalent with p-value > 0.05.

Conclusion

Sirius tomography is more accurate in IOL power calculation than Nidek optical biometry.
Comparison between Intraocular Lenses TECNIS EyhanceTM IOL and AcrySof®
Authors: Badawy Mostafa Mahmoud , Ismail Zafer Fahim , Shafik El-Ridy Ahmed , Abd-Ellatif Mahmoud Abd-Elmaguid
Published: November 2024

Background

Cataract is a common eye disorder that, if left untreated, can result in significant impairment of mental health, quality of life, function, and dangerous falls. Presbyopia correction during cataract surgery is becoming more common, and patients are requesting it more.

Objective

To assess the effect of extended depth of focus for monofocal IOLs on the unaided intermediate distance visual acuity and to compare between AcrySof®IQ clear IOL and TECNIS EyhanceTMIOL results in contrast sensitivity.

Methods

The study was Prospective cohort study and will be conducted at Ain Shams hospitals by donations, after the approval of the research ethical committee, between November 2022 to June 2023, Follow up the patient three times (first day after operation, one month after operation and 6 month after operation).

Results

Typical monofocal aspheric IOLs have been designed with negative spherical aberration (SA) to compensate for the human cornea's average positive SA as ACRYSOF™ IQ CLEAR SA60WF that we used in this study. Results of this study revealed after six month postoperative, we can see there was no big difference in best corrected far vision between the two IOLs or in contrast sensitivity, but we can notice better unaided intermediate visual acuity with Eyhance IOL.

Conclusion

The results from this study demonstrated the safety and effectiveness of the enhanced monofocal IOL, Model ICB00, and to show evidence of an improvement in intermediate vision with comparable distance vision and dysphotopsia profile similar to a standard monofocal AcrySof™ IQ Aspheric IOL Model SA60WF. As a result, the enhanced monofocal IOL will provide patients undergoing cataract surgery with an alternative to standard monofocal IOLs, which might offer improved functional performance in daily life.
Efficacy of Amniotic Membrane Grafting Compared to Mucous Membrane Grafting in Reconstruction of Contracted Eye Socket: A Systematic Review and Meta-Analysis
Authors: Mohamed Sara A , AbdElaziz Dina E , Fawzy Samah M , Elsawy Ali M
Published: November 2024

Background

Successful reconstruction of contracted sockets requires the implantation of an allograft or auto graft. Amniotic membrane and oral mucosa are still the most commonly used substitutes for reconstruction of large conjunctival defects in contracted eye sockets.

Aim of the Work

To conduct a systematic review and meta-analysis estimating the efficacy of amniotic membrane versus mucous membrane grafting in reconstruction of mild to moderate contracted eye sockets.

Materials and Methods

A comprehensive literature search was conducted across the following databases: Google scholar, PubMed, MEDS, web of science, EMBASE and Cochrane Library for published studies from the 1st of January 1990 to the 1st of December 2022. According to the inclusion and exclusion criteria, four studies (published between 2006 and 2018) were included in the presented meta-analysis; they included 72 patients with mild to moderate contracted eye sockets.

Results

This study demonstrated a higher average upper fornix (UF) depth among patients in amniotic membrane grafting (AMG) group as compared to patients in mucous membrane grafting (MMG) group with a difference of + 1.08 mm in favor of AMG group, the overall effect is border line significant P = 0.06. Also, a higher average lower fornix (LF) depth was found among patients in AMG group compared to patients in MMG group with a mean difference of + 0.99 mm in favor of AMG group, the overall effect is highly statistically significant P < 0.0001. The average socket volume was higher in AMG group in comparison to patients in MMG group with a mean difference of + 0.14 mm in favor of AMG group, and the overall effect is border line significant P = 0.05. A lower percentage of complications was found in AMG group (21.6%) as compared to MMG group (26%) with no significant difference statistically; P value >0.05.

Conclusion

The presented analytical study revealed that AMG achieves superior clinical results in comparison to the MMG in reconstruction of mild to moderate cases of contracted sockets regarding socket volume, and upper and lower forniceal widening. It also carries lower risk of complications.