bluuebunny/crossref_metadata_2025 huggingface dataset:
Custodiol for myocardial protection and preservation
Authors: Gobran M A , Elkerdany A B , Elnahhas Y , Omar A H
Published: May 2020

Introduction

Custodiol cardioplegia is attractive for minimally invasive cardiac surgery, as a single dose provides a long period of myocardial protection. Despite widespread use in Europe, there is little data confirming its efficacy compared with conventional (blood or crystalloid) cardioplegia. There is similar enthusiasm for its use in organ preservation for transplant, but also a lack of data. This systematic review aimed to assess the evidence for the efficacy of Custodiol in myocardial protection and as a preservation solution in heart transplant.

Methods

Electronic searches were performed of six databases from inception to October 2013. Reviewers independently identified studies that compared Custodiol with conventional cardioplegia (blood or extracellular crystalloid) in adult patients for meta-analysis; large case series that reported results using Custodiol were analyzed. Next, we identified studies that compared Custodiol with other organ preservation solutions for organ preservation in heart transplant.

Results

Fourteen studies compared Custodiol with conventional cardioplegia for myocardial protection in adult cardiac surgery. No difference was identified in mortality; there was a trend for increased incidence of ventricular fibrillation in the Custodiol group that did not reach statistical significance. No difference was identified in studies that compared Custodiol with other solutions for heart transplant.

Conclusions

Despite widespread clinical use, the evidence supporting the superiority of Custodiol over other solutions for myocardial protection or organ preservation is limited. Large randomised trials are required.
Postoperative Complication in Overweight Patients Undergoing Coronary Artery Bypass Graft Surgery
Authors: Fedala M A , Metwaly H A , Hikal T S , Abdelmotaleb M A
Published: May 2020

Background

Considering the impact of obesity on mortality and morbidity after coronary artery bypass graft surgery (CABG), we had to investigate the association between central obesity and the body mass index (BMI) and the post-CABG mortality and morbidity.

Methods

98 patients with multi-vessel CAD and candidate for CABG were included in the study, and divided into two groups Group I: 53 patients with BMI over 30.Group II: 45 patients with BMI under 30. The primary end point was wound infection and mediastinitis. Secondary end points included mortality, prolonged ICU and hospital stay, stroke,renal and hepatic impairment

Results

Total of 98 patients (36 female) with amean age 54 + 6.5.group 1(53 patients) with BMI more than 30 and group2 (45 patients) with BMI under 30.wound infection ,mediastinitis, intensive care unit (ICU ) and in-hospital stay were significantly increased in patients with BMI ≥ 30 with (p value = 0.025, 0.02, 0.04) respectively.

Conclusion

Obesity was associated with wound infection and mediastinitis more than non-obese patients This lead to long ICU and in-hospital stay. And not associated with other morbidity or mortality
Comparison of Single and Double Chest Tube Drainage Management in Patients Undergoing Thoracotomy
Authors: Elnori A A , Elsayed H H , Mostafa A M , Kamal M M M
Published: May 2020

Background

chest tube is the most commonly performed surgical procedure in thoracic surgery practice. It is defined as insertion of (chest tube) into the pleural cavity to drain air, blood, bile, pus, chyle or other fluids.

Aim of the Work

comparison of single and double chest tube drainage management in patients undergoing thoracotomy in the form of pain score, hospital stay, total drainage, residual collection after removal of chest tube and need for another chest tube at Cardiothoracic Academy Hospital and Ain Shams University Specialized Hospital (ASUSH).

Patients and Methods

this study was conducted on patients who undergone thoracotomy at the Cardiothoracic Academy Hospital and Ain Shams University Specialized Hospital throughout the last 6 months from March 2018 till August 2018. Data was collected retrospectively from 40 patients, 20 patients in each group. In the 20 patients in the ‘single-tube group', only one chest tube was inserted, and in the 20 patients in the ‘double-tube group', two chest tubes were inserted. Pre-, intra- and postoperative variables in both groups were compared.

Results

40 patients met all inclusion criteria. The pre- and intraoperative characteristics of the patients were similar in both groups with no significant differences. The single-tube group was found to have a lesser amount of total pleural drainage than the double-tube group but there was no significant difference 202.50 cc vs 297.50 cc, respectively; (p > 0.05).

Conclusion

our results showed that the single chest tube drainage is more effective, reduces postoperative pain, hospitalization times and duration of drainage in patients who undergo thoracotomy.
National data on non-modifiable risk factors of coronary artery diseases in Egypt
Authors: Sedky M , Hassan W , Sedky N , Zarif B
Published: May 2020

Background

CAD accounts for approximately 42% of all cardiovascular deaths. A lot of predisposing risk factors for CAD exist and they are generally divided into modifiable and non-modifiable risk factors. Genetic variants were found to be among the non-modifiable risk factors where they strongly contribute to the incidence of CAD in Egyptian populations.

Purpose

highlighting the different genetic polymorphisms and non-modifiable risk factors for CAD in Egyptians and ranking them according to the degree of importance.

Methods

Intensive research was done in the period between 15 May 2018 and 15 September 2018 on both Science Direct, SCOPUS and Pubmed with the keywords (((myocardial infarction) OR (myocardial ischemia) OR (MI) OR (coronary artery disease) OR (CAD)) AND ((risk) OR (risk factors)) AND ((Egypt) OR (Egyptian))). 1060 studies were retrieved. Three reviewers screened the results and chose 84, from which, only 7 studies from 7 different centers from different parts of Egypt shown on map were included after full text screening with total no of 523 of various coronary artery disease patients and 396 healthy matched controls. Exclusion criteria was as follows: Full text not available (only abstract or protocol is published)The study was not randomized with a risk of biased resultsThe presence of any other comorbid disease as renal failure and autoimmune diseasesThe absence of control group in the study.

Inclusion criteria was as following: Randomized controlled studyCross sectional studiesMean age of the patients above 30 years oldStudy on Egyptian populationsFull text and results available

Results

The polymorphisms (TPA, PAI-1, Paraoxonase-1, Manganese superoxide dismutase Ala16Val polymorphism, Platelet derived growth factor B gene polymorphism, rs854560 PON1, rs1790349 and rs12785878 of NADSYN1/ DHCR7 Locus, rs10741657, rs2060793, rs1993116 and rs10766197 of CYP2R1) demonstrated a significant association with the incidence of CAD in the Egyptian population. The odds ratios (ORs) for the putatively at high risk homozygous genotype vs. other genotypic groups of the different polymorphisms are shown clearly in the figure 1. The highest association is recorded for SNP rs1993116 of the CYP2R1 gene (ORs 8.5), followed by manganese superoxide dismutase Ala16Val polymorphism (ORs 3.6).

Conclusion

Many SNPs were found to be associated with CAD incidence in Egyptians, on top of which lies the SNP rs1993116 of the CYP2R1 gene and manganese superoxide dismutase Ala16Val polymorphism
Study of The Polymorphism BsmI and TaqI in Vitamin D Receptor Gene in Egyptian Patients With Chronic Kidney Disease
Authors: Mohamed F M K , Osman M M , Nessim I G , Abdelmageed A I , Abdelsattar H A , Waked E A
Published: May 2020

Background

Chronic kidney disease (CKD) is a major public health problem and a leading cause of morbidity and mortality worldwide. Chronic kidney disease mineral and bone disorders (CKD-MBD) is a common complication of CKD and an important cause of morbidity and decreased quality of life. Serum levels of 25-hydroxy vitamin D and parathyroid hormone (PTH) provide an accurate picture of bone turnover and mineralization states therefore they could be used with other serum bone biomarkers as non-invasive sensitive bone markers to help management of MBD in CKD. Due to the complex role played by vitamin D in kidney disease, the genotyping for vitamin D receptor (VDR) variants in CKD patients has been regarded as a way for improving the management of the disease.

Objective

The aim of the present work was to study the association of vitamin D receptor gene polymorphisms BsmI and TaqI with the chronic kidney disease and to assess its relationship with development and progression of chronic kidney disease-mineral bone disease.

Subjects and Methods

The study was conducted on 60 CKD-MBD patients in addition to 30 age- and sex- matched subjects serving as a healthy control group. Patients were subdivided into two subgroups according to the stage of CKD: subgroup 1a; 30 patients with CKD-MBD under conservative management (stages: 3 and 4 CKD) and subgroup 1b; 30 CKD-MBD patients with end-stage CKD on regular hemodialysis. Determination of BsmI (rs1544410, A>G) and TaqI (rs731236, C>T) polymorphisms of VDR gene was carried out using restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR).

Results

The result of the present study revealed that VDR BsmI (rs1544410) gene polymorphism and alleles (Bb, bb) were not associated with susceptibility to the CKD or development and progression of CKD-MBD in the studied CKD-MBD patients. However, having the gene variants of VDR TaqI (rs731236) tt homotypic genotype increased the susceptibility to CKD-MBD compared to having the gene variant TT wild genotype and Tt heterotypic genotype. Moreover, VDR polymorphisms were associated with the mineral status in CKD-MBD Egyptian patients. The VDR BsmI wild (BB) genotypes and the VDR TaqI homotypic (tt) variant were found to be associated with development of severe secondary hyperparathyroidism, hypocalcemia and vitamin D deficiency in the studied Egyptian patients with CKD-MBD.

Conclusion

VDR BsmI gene polymorphism failed to prove any association with susceptibility to the CKD or development and progression of CKD-MBD. However, VDR TaqI tt homotypic genotype increased the susceptibility to CKD-MBD and progression toward severe secondary hyperparathyroidism, hypocalcemia and vitamin D deficiency.
Study of the Levels of Advanced Glycation End Products in Sickle Cell Patients
Authors: Shalaby N A , Elgamal R A , Kenny M A , Sabrah A A
Published: May 2020

Background

Sickle cell disease (SCD) is a hemoglobinopathy characterized by hemolytic anemia, increased susceptibility to infections and vaso-occlusion leading to reduced quality of life and life expectancy. SCD is caused by a point mutation in a single gene, which results in a mutant β-globin protein (HbS), in which the sixth amino acid is changed from glutamic acid to valine. In the homozygous and some compound heterozygous states, deoxygenated HbS molecules form polymers, which damage the red cell membrane and increase its rigidity.

Aim of the Work

to study the AGE levels in sickle cell patients and determine its relationship to the presence of SCD-related organ complications, in addition to exploring the association of AGE levels to other clinical and laboratory data.

Patients and Methods

This study was conducted on 40 Sickle cell patients, including sickle cell anemia (HbSS) and compound heterozygous states. In addition to 20 race, sex, and age matched healthy control subjects will also be included. They were recruited from patients attending Pediatric Hematology Clinic, Pediatric Hospital, Ain Shams University from September 2017 to September 2018. A verbal informed consent was taken from all patients.

Results

A statistically significant difference was found between SC patients and control group as regards their CBC data; including TLC, which showed a significant statistical difference being higher in patients group (P < 0.001).

Conclusion

Plasma levels of pentosidine and CML are increased and associated with haemolysis and haemolysis-related organ complications in sickle cell patients, suggesting that AGEs might be implicated in vascular damage and chronic organ complications in SCD. Measurement of these AGEs might be useful in assessing disease severity and predicting organ complications in SCD.
Association of CYP2J2 Gene Polymorphism with Ischemic Stroke
Authors: Elhadidi E S , Hamed A I , Abdelsattar H A , Amer A S A
Published: May 2020

Background

Stroke is regarded as a severe disorder with high morbidity and high mortality, which is a major healthcare problem and a serious economic burden worldwide. It claims over 6 million deaths each year worldwide.

Aim

To investigate the association of CYP2J2 gene polymorphism with increased risk of ischemic stroke in a group of Egyptian patients.

Subjects and Methods

This study was conducted at Clinical Pathology and Stroke Units of Ain Shams University Hospitals, between November 2017 and July 2018. A total number of 30 subjects were included (20 patients and 10 controls).

Results

Our study concluded that risk of hypertension is higher in heterozygous GT population (100%) compared to the wild type (51.22%), whereas no significant increase in the ischemic stroke risk was observed between wild and heterozygous groups.

Conclusion

The most frequent genotype among the chosen sample of Egyptian population in the study (acute ischemic stroke patients and controls) was the wild TT genotype although not statistically different than other genotypes.
Frequency and Risk Factors of Voice Problems among Teachers
Authors: Fahmy V F , Elokda E E , Abdelhamid M A , Momen M
Published: May 2020

Background

Voice problems are thought to be one of the major occupational hazards of school teaching; as teachers often use their voice with high-intensity, in noisy classes, for a long time and without suitable breaks. The measurement of vocal demands and risk factors is essential for adjusting occupational safety and health services to this population’s needs.

Aim of the Work

To estimate the prevalence of voice problems and to identify the possible risk factors for developing voice pathology among primary school teachers.

Materials and Methods

A cross sectional study was carried out in 10 primary schools in Cairo, Egypt. A total of 225 primary school teachers were invited to participate in the study. Data were collected through an interview questionnaire addressing the prevalence of voice problems and potential risk factors. Descriptive analysis and chi-square test were used to measure the relationship between voice problems and associated risk factors.

Results

The frequency of voice problems among teachers was 56.4% at any point of time throughout their career. The teachers reporting voice problems were compared with those without problems. Gender was significantly associated with the development of voice problems among teachers.

Conclusion

A high frequency of self-reported voice problems was found among the studied teachers which indicates that school teaching is a high-risk profession for occurrence of voice problems.
Impact of mothers’ knowledge and coping strategies on glycemic control of Diabetic children Ain Shams University hospital, 2018
Authors: Khallaf N M R , Manzour A F , Kamaleldin A M , Meky F A
Published: May 2020

Background

Type 1 diabetes trends in Egyptian children have been increased in the past two decades. This study aimed to: a) Determine diabetes-specific knowledge level of diabetic children’s mothers. b) Measure maternal diabetes-related stress. c) Identify different coping strategies of the mothers in response to their children’s illness. d) Determine the effect of the level of mothers’ diabetes specific knowledge, their score of stress, and their coping strategy on glycemic control of their diabetic children.

Methods

A cross sectional study was conducted in the outpatient clinic for diabetic children at a University hospital between February and August, 2018 in Cairo, Egypt. A Systematic random sample of 104 mothers of diabetic children aged between 2 to 14 years was taken. Diabetes-specific knowledge was measured by using the Diabetes Knowledge questionnaire-24 .Stress and coping strategies were measured by the Ways of coping questionnaire.Hba1c levels of their children were taken from medical records.

Results

The study showed that approximately two-thirds of the mothers (61.5%) had good diabetes-specific knowledge levels, 45.2% of them had high levels of diabetes-related stress. The most common adopted coping strategy by the mothers was acceptance of the disease. Glycemic control of the child was negatively correlated with positive thinking about the disease (r=-.2, p=.042) and acceptance of the disease (r= -.3, p=.002).While, it was positively correlated with cognitive restructure (r=.262, p=.007) and emotional numbing (r=.2, p=.042). There was no significant relation between maternal diabetes-specific knowledge levels, their stress levels and Hba1c levels of their children.

Conclusions

mothers who were able to adopt positive coping strategies such as: acceptance of their children’s disease and positively think about it, might maintain a better glycemic control in their children.
Assessment of Serum and Tissue YKL-40 in Egyptian Psoriasis Vulgaris Patients versus Controls
Authors: Shaheen M A , Elzawahry K M , Georgy F W
Published: May 2020

Background

Psoriasis is an inflammatory, papulosquamous disease of the skin. Serum YKL-40 is a useful biomarker of inflammation in psoriasis as well as other inflammatory diseases.

Objectives

To compare the levels of serum and tissue YKL-40 as a reliable biomarker of inflammation in psoriasis vulgaris patients versus controls.

Patients and methods

We performed a case-control study in 30 Egyptian patients with psoriasis vulgaris and 30 controls. Cases and controls were selected excluding pregnant females, individuals with any malignancies, patients who received systemic treatment for psoriasis for 1 month prior to their inclusion in the study and patients who received topical treatment for psoriasis 2 weeks prior to their inclusion in the study. The serum & tissue levels of YKL-40 were measured using ELISA technique.

Results

Both the serum and tissue levels of YKL-40 were elevated in psoriasis patients when compared with controls (p < 0.01). These levels correlated highly with PASI score; both serum and tissue YKl-40 levels were significantly higher in patients with moderate psoriasis as compared with those with mild psoriasis. On the other hand, there was no statistical correlation between the serum and tissue levels of YKL-40 and age, BMI or disease duration.

Conclusion

The significant elevation in serum and tissue levels of YKl-40 in psoriatic patients when compared with healthy controls validates the marker in question as a reliable biomarker of inflammation in psoriasis vulgaris patients.
Conventional Photodynamic Therapy versus Fractional CO2 Laser Assisted Photodynamic Therapy in Treatment of Onychomycosis
Authors: Abdallah M M A , Mahmoud M T , Soltan M Y , Abughali M M M
Published: May 2020

Background

Onychomycosis is a common persistent infection of the nail unit by fungi either dermatophytes, yeasts or non-dermatophyte molds (NDMs). It is classified clinically to distal and lateral subungual onychomycosis (DLSO), superficial white onychomycosis (SWO), proximal subungual onychomycosis (PSO), candidal onychomycosis, endonyx onychomycosis and total dystrophic onychomycosis (TDO). Onychomycosis is commonly confirmed by clinical examination side by side with regular diagnostic techniques such as direct microscopy and fungal culture, which are considered the golden are considered the golden standards of diagnosis.

Aim of the Work

to evaluate two PDT approaches in the treatment of onychomycosis. The study will compare the effect of PDT using conventional method versus fractional CO2 assisted PDT for achievement of a clinical and mycological cure in cases of onychomycosis.

Patients and Methods

we conducted a right-left controlled study, on 21 patients with at least 2 toenails onychomycosis in the same patient. These patients were recruited from outpatient clinic of dermatology department at Ain Shams University Hospitals. The study was conducted during the period from December 2016 till June 2017. Twenty-one patients (4 males and 17 females) with clinical signs of toenail onychomycosis were enrolled in the study. The diagnosis was confirmed via laboratory studies.

Results

in our study, we found that Aspergillus species were the most common causative organisms of OM followed by and this is possibly because the non NDMs are more frequent in tropical and subtropical areas with a hot and humid climate. Conventional PDT and fractional CO2-assisted PDT have an antifungal activity as manifest by a mycological cure rate of 57.1% and 76.2% in OM cases respectively. Fractional CO2-assisted PDT was superior to conventional PDT as regard the clinical improvement in nail appearance and patient satisfaction.

Conclusion

non-dermatophyte molds are important and common pathogens in toenail onychomycosis. Aspergillus species play an important role as pathogens for toenail onychomycosis in Egypt.
Comparative Study on the Efficacy of Diphenylcyclopropenone Alone and in Combination with Intralesional or Systemic Corticosteroids for the Treatment of Extensive or Refractory Alopecia Areata
Authors: Rasheed A I E , Soltan M Y , Mohammed N N
Published: May 2020

Background

Alopecia areata (AA) is an autoimmune disorder characterized by transient, non-scarring hair loss with preservation of the hair follicle. It affects nearly 2% of the general population at some point during their lifetime. Extent of the disease can vary widely from localized hair loss in well-defined patches to diffuse or total hair loss, which can affect all hair-bearing sites. Patchy alopecia areata affecting the scalp is the most common type.

Objectives

The aim of this study is to evaluate the efficacy and safety of topical diphenylcyclopropenone alone and in combination with intralesional steroids or systemic steroids for the treatment of extensive and/or refractory cases of alopecia areata.

Patients and Methods

The study included 21 patients suffering from alopecia areata during January 2018 till November 2018. They were recruited from the Outpatient Clinic of Dermatology, Ain Shams University Hospital and El-houd EL-marsoud Hospital. All patients gave written consent to participate in this work after explanation of the technique, expectations, possible side effects and alternative treatments. The study was approved by Research Ethical committee of Ain Shams University.

Results

We found that about three quarters of AA patients were males and majority were young adults aged 15 to 50 years. The duration of the disease was more than one year and mean age of first onset was 15 years. About half of the patients was of refractory type. All patients recalled previous history of AA and 90% treated by combined therapy. Scalp was affected in all patients and eyebrow in half of them while nails were affected in 10%. Mean SALT score at time of presentation was 59%. Dermoscopic examination revealed that majority of the patients (95%) had yellow dots; two third had black dots and vellous hair; while exclamation and short thin hairs were found in approximately one third of the patients. The study found that there is statistically significant difference between mean SALT scores among the three treatment modality groups at start of treatment course specifically between group II (40.6 (±20.9)) and group III (82.5 (±21.7)) (p = 0.04).

Conclusion

DPCP is an effective and safe treatment of extensive and refractory AA especially with intralesional steroid. Older age at onset of the disease is good indicator for a better prognosis. No statistical significant difference between treatment modalities regarding response stratified by other demographic and clinical feature of AA patients.
Psychiatric co- morbidity among learning-disabled children
Authors: Alnne R A , Azzam A A , Shadi M S , El-sady S R , Aboelella E I
Published: May 2020

Background

Despite a strong reciprocal association between dyslexia and behavioral problems in children, their co-occurrence is often under-recognized and under-treated resulting in less than optimal outcomes in all areas including academic emotional outcomes.

Aim of the Work

The primary goal of this study was to identify the co-morbid behavioral problems in dyslexic children and delineate its types to minimize its burden on dyslexic children; in order to design a better management plan.

Patients and Methods

This study was conducted on 62 dyslexic children between the ages of 6 to 10.5 years, belonging to different socioeconomic standards. They were subjected to the Learning Disabilities assessment protocol (including Modified Arabic Dyslexia Screening Teat , MADST )of the Phoniatrics Unit, Ain Shams University also they were subjected to the Arabic version of the Childhood Behavior Checklist (CBCL) which was conducted at the Psychiatric Unit, Ain Shams University.

Results

Reading disabilities was positively correlated with total behavioral problems, internalizing behavioral problems, anxiety, depression, social and attention problems, while there was no significant association with somatic, thoughts problems and externalizing behavior (aggression and rule breaking behavior).

Conclusion

this study showed that reading disabilities is associated with behavioral problems, which may affect the efficiency of there habilitation program
Relation between cortical auditory evoked potentials and behavioral auditory discrimination in cochlear implant children
Authors: Shalaby A A , Elkholy W A , Hassan D M , Mohamed A M
Published: May 2020

Background

Cochlear implants (CI) can partially or totally revert the effects of sensory deprivation; thus enabling the development of auditory abilities. However, there remains a large amount of variability in speech perception outcome among CI users. Such variability may be attributed to the children’s diverse capabilities in detecting amplitude, temporal and spectral changes in the incoming complex speech signals in quiet and in difficult listening situations.

Objective

To study whether the newly introduced Acoustic Change Complex (ACC) cortical potential using short duration can be used to document such variability. If used as a tool for cortical discrimination, it will aid in evaluating young children who cannot be tested using behavioral measures.

Patients and Methods

Cortical auditory evoked potentials were recorded in forty five unilaterally-implanted children ranging in age from 6 to 12 years. Stimuli used to elicit ACC were short duration (500 msec.) speech and tonal stimuli. Spectral change was done using /i/ to /u/ vowels, while temporal change was done using variable gaps-in-1000 Hz tone, ranging from 5 msec. to 200 msec. Auditory evoked responses were compared to behavioral tests which included speech perception test (PBKG) and psychophysical test for temporal resolution.

Results

ACC potentials were successfully recorded in most of the children evaluated. Generally, ACC were significantly highly detected in temporal changes than spectral change. Individual data showed that poor behavioral performance was associated with higher ACC detection thresholds to gap in tone and poorer % detection to vowel change. Conclusion: ACC potential using short duration stimuli can be recorded in young implanted children in an ordinary clinical setting. However, more research is needed to document the complex behavioral-objective relationship and its ultimate link to speech perception and language development in young CI recipients.
Screening of Autism Spectrum Disorder in Metabolic Disorders by M-CHAT R/F
Authors: Abdelwareth L M , Ghandour H H , Abdelhakim A S , Elrefaie D A , Shata M O
Published: May 2020

Background

no exact cause can be defined for autism spectrum disorder (ASD) but, recent studies proved a great association between the presence of ASD symptoms and different metabolic disorders which provides a great consideration in diagnosis and treatment of children with ASD.

Aim of the Work

is to detect the prevalence of ASD among children with metabolic disorders using M-CHAT-R/F as a screening tool.

Patients and Methods

An analytical (observational) cross sectional research design. The subjects of this study comprised a convenient sample of 100 children diagnosed as having Metabolic Disorders with age range between (16-30) months. The validated Arabic version of Modified Checklist of Autism- Revised and Follow up (M-CHAT R/F) was applied for all children.

Results

screening of 100 children with unequal distribution among 13 types of metabolic disorders for ASD by use of M-CHAT-R/F found 22% had low risk (safe), 58% had moderate risk and 20% had high risk.

Conclusion

children with metabolic disorders are at a high risk for ASD. Early detection of these cases provides early intervention and better outcome.
Elective Neck Dissection in T1T2 Oral Squamous Cell Carcinoma with Proven N0 Neck: Essential or Not? A Meta-analysis Study
Authors: Ibrahim S A , Elsersy H A , Abdelhamid A N , Darahem I M H
Published: May 2020

Background

Oral squamous cell carcinoma (SCC) is characterized by a high risk of metastases to lymph nodes in the neck. The incidence of occult cervical metastases is relatively high. Surgical resection is the treatment of choice. Our study included patients with early oral cancer (T1/T2) Squamous cell carcinoma with proven N0 Neck.

Objective

The aim of the present study was to evaluate the need for elective neck dissection (END) in T1/T2 oral squamous cell carcinoma with proven N0 Neck.

Patients and Methods

a meta-analysis for the evaluation of recurrence rate after neck dissection in early oral cancers was conducted. This study included published English medical articles in the last 30 years, concerning early oral SCC with proven N0 Neck. (24) articles were included with a total number of 2192 of patients and 1619 controls.

Results

There was a significant heterogeneity among the included studies. Regarding the regional recurrence rate, neck dissection (ND) was associated with significantly lower risk of recurrence when being compared with observation. Regarding the 5-year survival rate, (10) studies were included with a total number of 1211 of patients and 948 controls. There was no significant heterogeneity among the included. There was a statistically significant difference between ND and Control.

Conclusion

Elective neck dissection is better than observation in early oral cancers T1/T2 N0 neck.
Single Sitting Bilateral Myringoplasty: Outcomes and Complications
Authors: Hassan M A , Hassaballah M S , Mikahail P M , Mahmoud M S D
Published: May 2020

Background

Tympanoplasty is the standard and well established procedure for closure of tympanic membrane perforations. Traditionally each ear drum is taken up for grafting sequentially in two different sittings. The reluctance to deal with both sides at the same sitting has been primarily due to a theoretical risk of iatrogenic sensory-neural hearing loss, need of bilateral ear canal gauze packing and chances of graft intake failure. Chronic Suppurative Otitis Media (CSOM) is a widely prevalent public health problem presenting with discomfort, hearing loss, otorrhea and psychological trauma. CSOM is characterized by an inflammatory process of the middle ear often associated with irreversible tissue alterations. It may be further classified into safe chronic otitis media and unsafe chronic otitis media according to the absence or presence of a cholesteatoma.

Aim

This study aim at assessing the single stage bilateral surgical procedure in bilateral tympanic membrane perforation caused by chronic otitis media as regard the graft take and hearing improvement as outcomes.

Methodology

A meta-analysis study is done to assess the feasibility and the possibility of operating the bilateral perforation in tympanic membrane in chronic otitis media cases on same session rather than doing it in separate sessions. The outcomes that were selected to evaluate such approach are graft take and hearing improvement. Hospital stay, cost of the operation and time were supposed to be evaluated however, there was no sufficient data to treat such outcomes in this meta analytic study upon that these outcomes are going to be appraised and stated bases on the available data.

Results

The graft take was evaluated on the bases paper by ototscopic examination post operative from 3 weeks to 3 months by closure of the perforation. It was estimated in this study to be 88%. This percent is matching the result obtained by Ihsan et al 2016 “who operated on 50 patients with a graft uptake rate of 86 %”, Olusesi et al, 2017 " with a total of 38 participants underwent either bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential different-day tympanoplasty (20 patients, 40 ears). The overall graft take rate was 88 per cent (32 out of 36 ears in the same-day tympanoplasty group, 35 out of 40 ears in the different-day tympanoplasty group; p = 0.96, odds ratio = 0.984)" (88 %), and Katsura et al, 2005 who revised the SUM using a 17 patients who underwent bilateral same-day surgery with a success rate of (85%).

Conclusion

Simultaneous bilateral myringoplasty is safe and effective as a single-stage operation with a high success rate as regard the graft take and hearing improvement.
Three ounce Water Swallow Test versus Fiberoptic Endoscopic Evaluation of Swallowing for Evaluation of Laryngeal Aspiration
Authors: Ahmed S , Bassiouny S , Hafez N , Ghandour H , Salah M
Published: May 2020

Background

Screening of dysphagia by 3 ounce water swallow test (WST) is one of the most common screening tools especially among stroke patients worldwide and it is very important to avoid serious complications as pneumonia, guide starting oral alimentation.

Aim of the work

to compare the effectiveness of 3 ounce WST to the FEES results in determination of aspiration in order to guide oral feeding recommendation.

Patients and Method

This study included 39 patients recruited from the Phoniatric out-patient clinics of Ain Shams University Hospitals and Banha University Hospitals. They were subjected to doing 3 ounce WST after complete assessment according to protocol of dysphagia Ain Shams University and then doing FEES which used as the gold standard to compare the results of 3 ounce WST.

Results

Sensitivity of 3 ounce WST was 72%, specificity was 100%, false negative rate was 28% among patients of different diagnostic categories while Sensitivity of 3 ounce WST was 87.5 %, specificity was 100%, false negative rate was 12.5 % among stroke patients.

Conclusion

Although being simple, inexpensive and quick to perform, the 3 ounce WST is not sensitive enough to detect cases of silent aspirations. A large false negative rate exists. In addition, it does not differentiate between penetration or aspiration, if cough occurs, and thus not truly helpful in oral feeding recommendations.
Role of Botulinum Toxin Injection in Non Allergic Non Infectious Chronic Rhinosinusitis (A Systematic Review)
Authors: Mansour O I , Hamdy T A , Abdelhamid A N , Hussein I M N M
Published: May 2020

Introduction

Botulinum toxin is derived from clostridium botulinum, in the recent era it has been used in many aspects of medicine such as sialorrhea, aesthetic surgery and most recently in rhinosinusitis. Rhinosinusitis is defined as an inflammation of the membranes lining the nose and paranasal sinuses, characterized by nasal symptoms including itching, rhinorrhea and nasal obstruction. Rhinosinusitis represents a global health problem affecting between 10% and 25% of the world population.

Aim of the Work

Systematic review of the clinical trials, to detect the efficacy of using botulinum toxin locally in cases of non-allergic non-infectious rhinosinusitis and allergic rhinosinusitis.

Methodology

This is a meta-analysis study. The study included published medical articles about botulinum toxin injection for patients suffering from non-allergic non-infectious rhinosinusitis (NANIR) and patients complaining of allergic rhinosinusitis through searching the Medline data base.

Results

172 patients were included in our systematic review, where botulinum toxin was used locally in the nasal cavity, a clear symptomatologic benefit of BTX on both (NANIR) and allergic rhinosinusitis in terms of rhinorrhea, pruritis, sneezing, nasal obstruction. No systemic effects were reported, and 6 cases only reported epistaxis for 1week after BTX injection.

Conclusion

The available data favors the efficacy of usage of botulinum toxin for cases of (NANIR) and allergic rhinosinusitis, further randomized controlled studies must be conducted in the future.
Speech assessment in Down's Syndrome Children
Authors: Foda M I M , Nassar J F , Baraka M A S
Published: May 2020

Background

Down syndrome (DS) is the most prevalent chromosomal disorder appearing in 1 in 800 use births. The incidence rate is higher in mothers of aging above 35-years-old and increases with further advances in maternal age. It is named after John Langdon Down, the British doctor who fully described the syndrome in 1866.

Aim of the work

The aim of this study was to analyze the speech of children with Down's syndrome, in order to detect types and significance of speech disorders affecting speech intelligibility: to assist in putting the best strategy for therapy.

Patients and Method

Study design: A cross sectional study.

Participants

The study was conducted through 2 unfamiliar adult raters on 30 children with Down's syndrome regardless of sex. They were recruited among cases attending the Phoniatric Outpatient Clinic, Ain Shams University who fulfilled the inclusion criteria and agreed to participate in the study.

Conclusion and Recommendations

Based on the obtained results, Children with Down's syndrome have specific health needs that must be identified to help their particular problems in communication. They present with deficits in receptive and expressive language. Also, speech is particularly impaired in high percentage of those children. Children with Down syndrome could not clearly deliver their speech as their peers. The findings confirmed that all the children with DS showed at least one speech disorder affecting their speech intelligibility.

Recommendations

Of course, the above observations can only be considered preliminary and many more data and researches are needed by clinicians as people with Down's syndrome can now live to be much older than they could in the past and most wish to reach their maximum potential. Therefore, the clinicians should apply their skills in the differential diagnosis of speech disorders to children with DS and search for measures for the other types of speech disorders can't be assessed in our work (like motor speech disorders which were present in a high percentage in our study group), allowing better interventions to target the cause of the disorder in each individual and improve their quality of life.
Health Education Intervention Program for Osteoporosis Prevention among Female Employees of the Egyptian Electricity Transmission Company
Authors: Ebrahim D A , Boulos D N K , Abdulrahman S A , Baioumy E M , Sabbour S M
Published: May 2020

Background

Osteoporosis is a growing public health problem associated with aging of the population. Awareness programs have the potential to reduce osteoporosis risk as many risk factors are modifiable.

Objectives

This study aimed to estimate the prevalence of osteoporosis among female employees working at the EETC, to design, implement and evaluate the effectiveness of a health education program on osteoporosis and its prevention.

Methods

The study was conducted from July 2016 to August 2017 at the outpatient clinics of the EETC. The first step was a cross sectional study to determine the prevalence of osteoporosis among the EETC employees using DEXA. This was followed by a pre/post intervention study. Sample size was 185 female participants aged 50 years old and above. The educational program included two sessions 45-60 min each, with two follow ups in person and by telephone in addition to distribution of educational material. At baseline and post intervention a self-administered questionnaire, Osteoporosis Knowledge Assessment Tool (OKAT) and Osteoporosis Health Belief Scale (OHBS) were used to determine participants’ knowledge, beliefs and self- reported practices.

Results

Among 185 study participants 45 (24.3%) were osteoporotic, 100 (54.1%) had osteopenia while 40 (21.6%) were normal. Post intervention there was a significant increase in OKAT mean score ± SD (from 8.54 ± 3.46–12.26 ± 2.48, paired t test = 21.46 P = 0.001). Similarly, the seven subscales of the OHBS showed significant improvement of the attitude towards osteoporosis (P < 0.001). Self-reported practices concerning physical activity, dairy products and caffeine consumption, vitamin D and calcium supplementation showed statistically significant improvement following the education sessions.

Conclusion

Osteopenia is highly prevalent among study participants. The osteoporosis education intervention was effective in improving knowledge, changing health beliefs and preventive behavior.
Assessment of the possible association between phthalate exposure and attention deficit hyperactivity disorder in egyptian children
Authors: Mohamed S R , Mohammed N E A , Elzohairy E A M , Abdelsalam M H
Published: May 2020

Background

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric disorders of childhood. Phthalates are industrial chemicals often used in personal care products and to soften plastics in toys and household items such as food containers, and medical devices. Animal studies have reported that the phthalate compound might cause hyperactivity and impulsivity in rats. However, the relation between phthalates and ADHD in human is still controversial.

Objective

The aim of our study is to investigate the possible association between urinary phthalate metabolite levels and attention deficit disorder, learning disability in 6–12-years old children.

Methods

Urine samples were obtained from 80 children. All children were selected from the attendants of Abu elreesh child psychiatry outpatient clinic, Cairo University. subjects were divided into two main groups Group A consisted of 50 children with Attention-deficit/hyperactivity disorder (ADHD) diagnosed by psychiatric consultant and Group B consisted of 30 normal children. In urine, mono butyl phthalate (MBP) metabolite were measured with high performance liquid chromatography (HPLC).

Results

The mean concentration of MBP level was (15.539±8.316) for cases (group A) and (8.085 ±2.426) for controls (group B) with significant difference between groups. Also there was significant correlation with processing milk, plastic containers, toys, cosmetics, wall, and floor material containing phthalate exposure and higher level of (MBP) in urine of group A.

Conclusion

The present study showed association between phthalate metabolites in urine and symptoms of ADHD among school-age children.
Complications of Neck Dissection in Thyroid Malignancy
Authors: Alaaeldin H A , Farahat M S , Elhoofy A N K , Yonis A M M
Published: May 2020

Background

The normal thyroid gland is caudal to the larynx and encircles the anterolateral portion of the trachea. It is about 10 to 20 grams in weight in normal adults.

Aim of the Work

The aim of this study is to characterize the morbidity and complications of neck dissection in thyroid malignancy.

Patients and Methods

The present study will include 20 patients with thyroid cancer. All patients will undergo total thyroidectomy plus neck dissection. Neck dissection procedure was performed unilaterally in 16 patients (80%), and bilaterally in 4 (20%), making a total of 24 ND procedures.

Results

There were fifteen females (75%) and five males (52%), their age ranged between 26 and 70 years with a mean of 50 years. All patients were subjected to thorough history taking, complete clinical examination and vocal cord assessment by indirect laryngoscopy. Laboratory investigations (T3, T4, TSH, serum Ca, and routine laboratory work up), followed by neck ultrasonography (US), and computed tomography (CT) were performed for all patients, as well as chest X-ray, and CT chest when needed. Biopsy from suspicious thyroid lesion and suspicious cervical LNs (whether blind or US guided) was performed.

Conclusion

Morbidity and complications of neck dissection are numerous and variable so meticulous dissection is needed.
Risk Factors of Pancreatic leakage AfterWhipple’s Procedure
Authors: Elshamy A M , El-Sobky A S , Ahmed S A , Mansour S M
Published: May 2020

Background

Pancreaticoduedenectomy is the operative of choice in cases of resectable tumors of the periampullary region. Critical step in pancreatic surgery is no longer the resection itself but the reconstruction of the pancreaticoenteric anastomosis. Different methods of pancreatic reconstruction have been proposed aiming to limit the rate of leakage of pancreatic anastomosis.

Aim of the Work

to evaluate the risk factors of pancreatic remnant leakage after Whipple’s procedure as regards risk factors of the diameter of the pancereatic duct and the texture of the pancereatic remnant during operation (soft or firm).

Patients and Methods

A prospective study conducted on 30 patients who underwent pancreaticoduodenectomy in Ain Shams University Hospitals during the period from June 2012 to June 2018 to evaluate the risk factors of pancreatic leakage after Whipple’s procedure regarding pancreatic duct diameter and pancreatic remnant texture.

Results

60% of leakage group had soft pancreas and narrow pancreatic duct less than 3mm, while 40% of non leakage group had soft pancreas and narrow pancreatic duct less than 3mm.

Conclusion

strong correlation between postoperative pancreatic leakage and narrow pancreatic duct as well as soft pancreas. Statistics proved that correlation and also, the relation of high mortality rate among those who developed postoperative pancreatic fistula.
Single Scrotal Incision Orchiopexy in Children with Palpable Undescended Testis
Authors: Elatrash O A , Eldebeiky M S , Elsherbeny M S , Elhoofy A N , Hassan E A A
Published: May 2020

Background

Undescended testis or cryptorchidism is one of the most common congenital abnormalities of the genitourinary system in young boys, approximately 1-2% of boys at the age of 1 year have undescended testis, the disorder being unilateral in about 90% of cases and bilateral in about 10%.

Aim of the Work

We conducted this prospective study to assess the efficacy and safety of single-incision, transscrotal orchidopexy in children with palpable UDT.

Patients and Methods

A prospective study was adopted to fulfill the purpose of the study. The study was conducted at Pediatric Surgery Department, Ain Shams University Hospitals in Cairo. The included study population was pediatric patients with palpable, inguinal mal-descended testes who attend to Pediatric Surgery Outpatient Clinic, Ain Shams University Hospital till the fulfillment of the sample size.

Results

The most common sites of undescended testis were intracanalicular and scrotal neck regions. The most common postoperative complication was scrotal edema. Mean operating time was 21 minutes. There was no significant difference in the testicular size pre and post operative.

Conclusion

Based on these results, we concluded that the undescended testis represents a common pediatric problem requiring surgical intervention. Trans-scrotal orchidopexy is an effective, less invasive and highly acceptable cosmetically approach for the treatment of palpable undescended testis.