bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Non-alcoholic fatty liver disease among chronic kidney disease patients by Controlled attenuation parameter
Authors: Salem Mohamed Mahrous , Shawky Sahar Mahmoud , Behairy Maha Abd Elmoneim , Helmy Ahmed Fouad
Published: October 2021

Background/Aim

Preliminary data suggest an association between chronic kidney disease (CKD) and non-alcoholic fatty liver disease (NAFLD). The aim of this study was evaluate the frequency of NAFLD and its associated risk factors among nondiabetic CKD patients not on dialysis.

METHODS

A total of 40 subjects were enrolled in the study. Group A (30) Pre dialysis non-diabetic CKD patiens and Group B (10) normal subjects matched for age and sex as a control group. Liver stiffness measurement was used to detect liver fibrosis and CAP (controlled attenuation parameter) was used to detect and quantify liver steatosis (Fibroscan®). NAFLD was defined by CAP values ≥238 dB/m.

RESULTS

Results of the current study showed that CKD stage III was present in 17 patients (56.7%) and CKD stage IV in 9 patients (30%) and CKD stage V in in 4 patients (13.3%). The total frequency of presence of steatosis (CAP values ≥238 dB/m) whatever degree was significantly higher in CKD group than control; More than (53%) of CKD patients have NAFLD, and (30%) of control group have NAFLD. The severity of liver steatosis was negatively correlated with GFR, Hb and HDL, and positively correlated with Creatinine, BUN, CRP, Cholesterol, TG, LDL, SGPT, SGOT, FBG and HBA1C.

There was significant relation between steatosis and CKD etiology. (82.3%) of Patients with hypertension have Steatosis, (33.3%) of Patients with reflux nephropathy have steatosis, (16.7%) of Patients had other causes have steatosis, while patients had renal stones have no steatosis.

There was significant positive correlation between fibrosis degree and age of CKD patients and also significant positive correlation between steatosis and fibrosis among CKD patients. The study showed significant positive correlation between SGPT and fibrosis degree.

The results suggest a high prevalence of NAFLD in non-diabetic CKD patients. The severity of liver steatosis is negatively correlated with kidney function; there was significant correlation between CKD stage and other risk factors of hepatic steatosis
Response of Ns5a inhibitors resistant patients to Qurevo-Sovaldi-Ribavirin regimen as a retreatment strategy for chronic hepatitis c virus infection
Authors: Moanes Ahmed A , Radwan Hesham H , Abd El Rahman Yasser O , Abd El Nabi Mostafa M
Published: October 2021

Background

Hepatitis C Virus (HCV) infection is a major global health challenge; it is estimated that more than 80 million people are chronically infected worldwide, with 3–4 million new infections and 350 000 deaths occurring each year because of HCV-related complications.

Aim of the work

to determine the efficacy of Qurevo-Sovaldi-Ribavirin regimen as a retreatment strategy in NS5A inhibitors (Sofosbuvir & Daclatasvir) resistant patients infected with chronic hepatitis C virus.

Patients and Methods

An observational cross-sectional study was carried out on 20 chronic hepatitis C virus infected patients in The centre of HCV treatment at El Quabary specialized centers in Alexandria where large number of patients receiving their HCV treatment.

Results

all patients (20/20) achieved sustained virological response after 3 months of the last dose of treatment (SVR12).

Conclusion

the new retreatment strategy composed of the triple therapy Qurevo (Ombitasvir/Paritaprevir/Ritonavir)/Sofosbuvir/Ribavirin is effective in the treatment of chronic HCV infected patients previously treated with Sofosbuvir/Daclatasvir/Ribavirin for 12 weeks without achieving sustained virological response (Ns5a inhibitors resistant chronic HCV patients).
The most prevalent allergenic airborne pollens among Egyptian patients with respiratory allergy
Authors: Refaat Maged M , Melek Nermine A.E , Ahmed Eman E , Abdellatif Osama M , Mohamed Manar F , Noor Al- Din Nada M
Published: October 2021

Background

Allergy symptoms occur when the immune system overreacts to environmental allergens, such as pollen or dust, which are typically harmless to most individuals but induce a potentially severe reaction to those who are sensitive to them. Pollen is one of the main reasons to cause seasonal allergic respiratory diseases and it is influenced by multiple risk factors.

Objective

To determine the most prevalent types of allergenic pollens by skin prick testing among Egyptian patients with respiratory allergy (asthma and/or allergic rhinitis).

Methods

200 adult patients, all were subjected to the following: full detailed medical history, clinical examination, asthma severity grading according to the GINA Guidelines, allergic rhinitis severity grading according to ARIA Guidelines, pulmonary Function tests for asthmatic patients. (PFTs), CBC with differential for detection of eosinophilic count, Skin prick testing (SPT) to common environmental allergens and common food allergen.

Results

The present study proved that the grass pollens; timothy grass and maize were the most prevalent pollens among Egyptian respiratory allergy patients.

Conclusion

Difference in results of SPT performed to patients across different countries is explained by the difference in climates, which affects pollination, Egypt is considered to have a dry, desert-like climate in addition to its coastal regions. Our results revealed that both timothy grass and maize pollens were the most prevalent among Egyptian respiratory allergy patients.
Studying the relationship between tobacco use and depression between Egyptian patients
Authors: Mohamed Ahmed Saad , ElHabiby Mahmoud Mamdouh , Elkholy Hussien Ahmed , Ahmed Ahmed DyaaEldeen
Published: October 2021

Background

Although much attention has been drawn to trends in smoking and smoking related diseases in the general population, increasing evidence suggests that patients with mental illness are at a high risk for tobacco use and nicotine addiction. Cigarette smokers usually state the antidepressant and anxiolytic effects of smoking, but evidence reports that cigarette smoking may promote negative effect, so that the causal direction of this association still mysterious. It was reported that there is a cause effect relationship between cigarette smoking and depression as multiple studies mentioned that tobacco use increases the risk of symptoms of depression. The relationship between smoking and depression was attributed to genetic predisposition, low level of dopamine, low self-esteem, and coping styles.

Aim of the Work

The current study aimed to study the pattern of tobacco use among patients with depression, to study the degree of motivation to quit in patients with depression, and to assess severity of suicidal behavior among patients with depression using tobacco.

Patients and Methods

This is a case control study conducted in patients with the diagnosis of depression attending the outpatient clinic or inpatient of the institute of psychiatry Ain Shams University Hospitals during the academic year 2018-2019. The sample size was consisted of 100 patients and the patients were selected randomly. The relationship between tobacco use and depression between Egyptian patients was assessed using Socioeconomic status scale (SES), Hamilton Rating scale for Depression (HRSD), FagerströmTest for Nicotine Dependence (FTND), Lebanon Waterpipe Dependence Scale-11 (LWDS-11), Reason for quitting scale (RFQ), Columbia–Suicide Severity Rating Scale (C-SSRS), and ICD-10 symptom checklist for mental disorders.

Results

The present study showed a statistical significant association between the following scales; Fagerstrom Test for Nicotine Dependence (FTND) and Hamilton depression rating scale (HDRS), Difference score of Reason for quitting scale (RFQ) and Hamilton depression rating scale (HDRS), and Fagerstrom Test for Nicotine Dependence (FTND) and Columbia–Suicide Severity Rating Scale (CSSRS).

Conclusion

Compared to non-depressive persons, the results showed that depressive groups were less desired for quitting smoking.
Pathway to Service and Duration of Untreated Attention Deficit, Hyperactivity Disorder among Children Presented to a Governmental, Mental Health Hospital in Egypt
Authors: Ramy Hisham Ahmed , Hashem Reem Elsayed , Khamis Marwa Esameldin , Abdelaziz Aya Alaa Said
Published: October 2021

Background

ADHD is one of the most common neurodevelopmental disorders. Despite the presence of evidence based approved diagnosing and treatment tools for ADHD, there still is an underdiagnoses and underutilization of these services.

Untreated ADHD, unlike what some families may believe, doesn’t go away on its own, in fact, the condition may get worse with age, affecting more domains of the child’s life as an adolescent and later on as an adult. In addition, untreated ADHD impacts not only the patient, but also the family and the society as a whole.

Objective

to investigate different routes that parents take before reaching the child and adolescence psychiatric services. And to further explore various reasons for any delay in seeking psychiatric help. In addition we aimed to estimate the duration of untreated ADHD before patients receive proper psychiatric service and treatment.

Patients and Methods

A total of 350 cases were recruited in a cross sectional study that took place at the Child and Adolescence outpatient clinic at Abbassia mental health hospital in Cairo, Egypt.

Results

Results showed that the average delay in seeking Child and Adolescence psychiatric service and the duration of untreated ADHD was 3±2 years. The majority of parents, 27.1%, first consulted pediatricians as regards to their child’s symptoms. The most commonly reported source of referral was school teachers in 23.1%. The most distressing symptom stated by 28.1% of parents was impulsivity. Stigma of mental illness was the most frequently reported reason for delay in reaching out for psychiatric service.

Conclusion

we concluded that parents tend to take other routes through different professions before reaching Child and Adolescence Mental Health Services, this causes subsequent delay in receiving diagnosis and treatment for ADHD. In Addition, it was concluded that sociocultural beliefs affected parent’s pattern of help seeking.
Psychiatric comorbidities among a sample of suicidal adolescents presenting to poison control center, Ain shams university
Authors: Abo EL Ella Eman Ibrahim , Sakr Mahmod Lotfy , Abd El-hamed Walaa Mohamed Sabry , saad Ali Hagar
Published: October 2021

Background

Suicide is a major cause of death all over the world with increasing risk especially in adolescents. Multiple studies have been conducted to study the risk factors and the underlying causes that lead to suicide. However, there is scarcity of data regarding suicide in adolescents. As it’s well known that most of psychiatric illnesses can be complicated with suicide especially those related to personality and substance use disorders.

For Egypt, adolescents represent almost one third of the total population, hence the importance of studying the risk factors and associated psychiatric comorbidities that may lead to adolescence suicide in order to reach proper intervention plans.

One of the most powerful double-sided weapons in that matter is the internet and social media use, as there has been a debate around whether it’s beneficial in seeking professional help or harmful as it may introduce methods of suicide and block any means of getting help

Hence, was the hope of this study to provide an understanding of the prevalence of suicide among adolescents and the underlying psychiatric comorbidities to reach proper intervention and prevention plans.

Aim of the Work

This study aimed at detecting the occurrence rate of suicide and suicide related behaviors and the underlying psychiatric comorbidities among a sample of 241 suicidal adolescents aged 12-18 presenting to poison control center, Ain Shams University and also To identify factors which are associated with high suicidal intent And compare the sociodemographic variables and the increase in electronic device /social use among adolescents with suicidal attempts versus non-suicidal adolescents.

Patients and Methods

This is a descriptive Cross-sectional study hospital-based study conducted in poison control center of Ain Shams University hospital. The present study aimed at detecting the occurrence rate of suicide among 241 adolescents, over six months period from February 2019 to July 2019. The socioeconomic status was assessed using Socioeconomic status scale (SES), the suicide intent was assessed using the beck suicide intent scale and the psychiatric comorbidities were assessed using the MINI International Neuropsychiatry Interview for children and adolescents kid scale
Effect of tele-stroke application on length of stay and outcome of stroke unit inpatients
Authors: El-khayat Naglaa Mohamed , Emara Tamer Hussein , Roushdy Tamer Mahmoud , Elmancy khaled Fayez
Published: October 2021

Background

Despite advances in acute stroke treatment, stroke remains the second most common cause of death and the leading cause for long-term adult disability worldwide

Telemedicine, a method of healthcare delivery and support using telecommunication technologies, is becoming increasingly popular across a wide range of health conditions. Tele stroke has grown significantly in the past decade and has entered mainstream care for patients with acute stroke. It enables such patients to be remotely evaluated, thereby allowing optimal treatment and management even in clinically underserved areas and removing geographical disparities in access to expert care.

Objective

Study the effectiveness of Tele-stroke regarding length of stay& stroke outcomes &occurrence of medical comorbidities in admitted patients by comparing these measures before and after tele stroke application in ain shams university specialized hospital(ASUSH)

Methods

Comparative observational study. we stratified patients into two groups:

“Group 1”: patients admitted 3 months before application of tele stroke

“Group 2”: patients admitted 3 months after application of tele stroke

We compared between two groups regarding sociodemographic data , length of stay and NIH scoring on admission & discharge before and after implementation of tele stroke system

Results

regarding length of stay, it was ranged from 1 to 19 days with mean (4.3 ± 3.3) in group (I) comparing to range 1 to 12 with mean (3.5 ± 1.9) days in group (II) with significant decrease (p = 0.033*).

By analysis of results by means for difference between NIH on admission and in discharge , the means difference in group I was 2.8±1.9 vs. 3.5±2.3 in group II with significant difference (p-value =0.29*)

CONCLUSION

Our study concluded that application of tele stroke had significant improvement in stroke unit care as regard length of stay, rapid improvement of patients according to NIH scoring and mRS
Sexual Behavior In preschool, school and preadolescents children A Sample from Outpatient’s Clinic of Pediatric Hospital
Authors: Taha Ghada Refaat Amen , Gad Ghada Ibrahem , Khamis Marwa Esameldin , Ali Zeinab Mohamed Ahmed , Ali Kholoud Ahmed
Published: October 2021

Background

Studies have suggested that Sexual behaviors are common in children. More than 50% of children will engage in some type of sexual behavior before their 13th birthday. Sexual behaviors in children range from normal and developmentally appropriate to abusive and violent. In retrospective study of 339 child welfare and mental health professionals in which participants were asked about their own experiences before 13 years of age, 73% recalled engaging in sexual behaviors with other children, 34% recalled showing their genitals to another child, 16% recalled simulating intercourse with another child, and 5% recalled inserting an object in the vagina or rectum of another child

Aim of the Work

To observe the developmental course of describe normative sexual behaviors in 2- to 12-years-old Egyptian children and to assess the relative frequencies of different types of sexual behaviors in general outpatient clinic of pediatric hospital of Ain Shams University hospitals.

Patients and Methods

This is a Cross sectional analytical started on October 2018. Study conducted in pediatric hospital Ain Shams University hospitals. This present study aimed at analyzing the data of 500 children aged from 2 to 12 years old. Thirsty four refused to participate on sexual behaviour questions.

Results

A total of 500 questionnaires were done by parents of child vising clinic of pediatric hospital of Ain Shams university, 35 refused to participate in sexual behaviour questionnaire. It was divided in three groups. Preschool aged children from 2-6 years 254 child (50.8%), school aged children from 6-9 years 106 child (18.82%) & preadolescents from 10 to 12 years 140 child (24.014%). The study Included both 252 males and 248 females. The most sexual behaviours detected among children “sometimes” were touching genitals at home 111(22.2%), child asks about sexual acts 86 child (17.2%) & saying sexual words 80 (16%) and mostly repeated children was flirt with strangers 11(2.2%) & asking about sex more than other children 10 (2%).

Conclusion

In general, sexual behaviors in children two to five years of age are of a greater variety and are more common compared with the behaviors in children older than five years. once the child becomes aware of social rules regarding sexual behaviors in public, those behaviors become more covert. There is a need for further national studies in different settings, to help create a better understanding of what constitutes both normative and deviant sexual behaviour in children.
VALUE OF MUSCLE MAGNETIC RESONANCE IMAGING IN COMPARISON WITH MUSCLE BIOPSY FOR DIFFERENTIATING VARIOUS TYPES OF LGMD
Authors: Ihab Sarah M , El-aidy Doaa A , Ahmed Khaled A , Fahmy Nagia A
Published: October 2021

Background

Limb Girdle Muscular Dystrophies (LGMD) are a clinically and genetically heterogeneous group of disorders which share progressive muscle weakness and degenerative muscle changes involving the shoulder and pelvic girdle muscles. The diagnostic approach is based on a comprehensive clinical history, a thorough physical examination, laboratory data, electrophysiological investigations, and particularly the histologic and immunoanalysis of a muscle biopsy, followed by a genetic confirmation of the diagnosis. Magnetic Resonance Imaging (MRI) complements clinical examination by delineating characteristic disease specific patterns of muscle involvement which helps in differentiation of individual LGMD subtypes. It is used to demonstrate the severity and distinguish between dystrophic and non-dystrophic diseases.

Objective

Identification of the value, sensitivity of Muscle MRI to be used as a tool for diagnosis and differentiation of patients with LGMD and as a guidance for the needed immunological and genetic studies to confirm their diagnosis.

Patients and methods

This study was conducted on 71 patients with clinical criteria of LGMD diagnosed by clinical, laboratory and dystrophic muscle biopsy from Myology Clinic and Neuromuscular Unit, Ain Shams University Hospitals, Muscle MRI was done blind from the results of muscle biopsy, immunohistochemistry and genetic studies. MRI muscles was done at mid-thigh, mid-leg levels. MRI Equipment was 1.5 Tesla in the Radiology department, Ain Shams University Hospitals (T1, Fat subtraction). MRI T1 images were obtained and muscle fatty infiltration in every single muscle was graded on a 5 point rating scale.

Results

The results showed that the diagnostic performance of muscle MRI in LGMD is most sensitive when calculated in examined Thigh muscles, followed by Leg muscles in comparison with muscle biopsy.

Conclusion

Muscle MRI is a practical, reproducible and valid tool that can be used in assessment of suspected LGMD patients.
Analysis of Health-Related Quality of Life of Patients with Clinically Localized Prostate Cancer After Treatment with Intensity Modulated Radiation Therapy (IMRT) Versus 3D Radiation Therapy
Authors: Abd-elhafeez Zeinab M , Nasr Khaled E , din Mai M. Ezz El , Makram Bassam E
Published: October 2021

Background

Prostate cancer is the most common malignancy in men. Patients with localized prostate cancer have multiple treatment options including active surveillance, prostatectomy, brachytherapy, and external beam radiation therapy (EBRT). Aim of the Work: to report on the quality of life outcomes in a number of male patients who underwent intensity modulated radiation therapy (IMRT) for clinically localized cancer prostate, compared to patients underwent 3D CRT, using licensed Arabic version of FACT-P questionnaire.

Patients and Methods

The present study included 103 patients diagnosed by localized prostate cancer. Patients files were collected from International medical center and oncology department at Ain Shams University hospital from June 2018 to December 2018. They were divided into two groups: Group I consisted of 51 patients treated using 3D CRT, all of them are under hormonal treatment. They completed a questionnaire at (Month 0) baseline, then on the followup visit, after 3, 6 months (Month 3, 6). Group II consisted of 52 patients treated by IMRT and hormonal treatment, the same dose range and field as 3D CRT. They participated and completed the questionnaire at the same phases (Month 0, 3, 6) with the same methods as the 1st group.

Results

stability in HRQoL (social and emotional subscales) in 3DCRT and the IMRT groups, and no significant difference among the two groups was observed throughout the follow-up period, although the radiation doses prescribed differed from one another. And showed a significant improvement in scores of (physical, functional and prostate concerns) subscales.

Conclusion

The two approaches used in this study showed similar patterns of alterations regarding general and disease specific HRQL with mild superiority for IMRT for the first 6 months after radiation therapy. Comparison of results between the 3DCRT and the IMRT groups revealed no substantial degrees of impairment in rectal toxicity and sexual function despite the dose escalation in the IMRT protocol. Thus, IMRT seems to offer a good treatment delivery approach with favorable HRQL outcomes.
Multi Institutional Retrospective Study about Median Survival Outcome for Women with Metastatic Triple Negative and HER2 Positive Breast Cancer in Egypt
Authors: Gazaly Hesham Ahmed El , Tawfik Ass. Prof. Dr. Amr Shafik , Saleh Essam , ElHameed Doaa Mohammed Abd
Published: October 2021

Background

Breast cancer is the most common malignant tumor among females around the world. It represents 1.7 million new cases per year and 25% of all types of cancers.

Objectives

Assessment of median overall survival in most aggressive subtypes of metastatic breast cancer (Triple –Ve and HER2+Ve) & to compare survival of metastatic HER2+Ve breast cancer in group received targeted versus that did not receive.

Patient and Methods

Multi institutional retrospective study for assessment of median OS in metastatic breast cancer for themost aggressive subtypes (HER2+Ve &Triple-Ve) at Ain Shams University Hospitals and El-Matarya teaching Hospital.

Results

Seventy-three metastatic breast cancer patients were included (31 Triple-Ve & 42 HER2+Ve) in the period between January 2014 and December 2016 At Ain Shams University Hospitals and El-Matarya teaching Hospital, we found that median OS for Triple negative group is 16 months with (95% CI 8.8- 23.6) , that for HER2+Ve group is 17 months with (95% CI 13.9 – 20.6) & for patients did not receive targeted therapy, median OS is 10 months (95% CI. 4-19.4,P.000).

Conclusion

From our study,we highlight that metastatic breast cancer patients (HER2+Ve subtype) &received targeted therapy, had the most superior survival outcome. so,targeted therapy must be included in first line treatment.
Prospective non interventional Study Evaluating Prognostic and Predictive value of PDL-1 expression and associated T-cell infiltration in Primary Laryngeal Squamous Cell Carcinoma
Authors: Tawfik Maha Maher , Wakiel Hesham EL , Lotfy Amr , Ghany Dalia Abd EL , Shakweer Marwa M
Published: October 2021

Background

Immune system plays an important role in cancer evolution. However, cancer cells affect the immune system and use it for its growth and survival. Tumor infiltration lymphocytes and PDL-1 expression proved to play an important prognostic role in different malignancies. We aimed at evaluating this role in laryngeal cancer.

Methodology

We prospectively analyzed the pre-treatment paraffin blocks for laryngeal cancer patients, whether on the laryngoscopy or operative specimens, to identify the CD8-positive cells in the tumor epithelium or stroma and the PDL-1 expression on the tumor cells. Appropriate tissue was used as positive control; placenta for PDL-1 and tonsil for CD8. A total score formed of the sum of percentage and intensity of PDL-1. A final comprehensive rate was considered as low expression when combined percentage and intensity score from 0 to 4, and high expression when score from 5-7. According to the distribution, the CD8+T cell invasion was divided into strong infiltration (> 10/100 of epithelial cells; >20/100 stromal cell infiltration) and weak infiltration (< 10/100 epithelial cells; < 20/100 stromal cell infiltration).

Results

40 patients were included in our study; 12 patients had early stage disease (I or II) and 28 with advanced stage (III or IV). PDL-1 expression was positive in 92.5%. Neither the PDL-1 nor CD-8 were found significantly correlated to OS in the whole population, however patients with advanced stage, median OS was significantly low for negative or low compared to high PDL-1 expression (11.7 vs 25.2 months (p = 0.036)), a trend of better OS in high CD8 Epithelial expression (25.1 versus 15.9, P = 0.514) and again trend of higher OS in high CD8 Stromal expression (25.3 versus 15.6 months, p = 0.375). Also there were significant correlation between the CD8 expression in the tumor epithelium and stroma with the PDL-1 expression with p-value of 0.001 and < 0.0001 respectively.

Conclusion

there is a positive correlation between tumor infiltration lymphocytes and PDL-1 expression in laryngeal squamous carcinoma and the higher PDL-1 expression in advanced stage laryngeal cancer is associated with better OS.
Induction chemotherapy with capecitabine and oxaliplatin followed by chemoradiotherapy before surgery in patients with locally advanced rectal cancer (A phase II study)
Authors: Elhawi Mai Ezzat , Azmy Aly Mohammed , Ghali Ramy Refaat Youssef , Gobran Ass. Prof. Dr. Nagy Samy , Shakweer Ass. Prof. Dr. Marwa Mosaad , Mohammed Doaa Atef
Published: October 2021

Background

Locally advanced rectal cancer (LARC) has a high incidence of local and distant relapse even after adequate treatment. The emerging role of neoadjuvant induction chemotherapy may allow initial down staging of the primary tumor, less toxicity profile and early treatment of micrometastatic disease followed by chemoradiation, and optimum local control may be attained, with the hope of increased complete response rates

Objectives

to identify the effect of induction chemotherapy with oxaliplatin and capecitabine (CapeOx) before concurrent chemoradiation in locally advanced rectal cancer in terms of response and toxicity. Primary end point is assessment of complete pathological response rate.

Patient and Methods

patients with MRI based criteria of high-risk LARC (T4 tumors, tumors within 2 mm of mesorectal fascia, T3 tumors at or below levators and T2-4N+ve tumors) were included. Patients received 12 weeks of induction capecitabine/oxaliplatin followed by concomitant capecitabine and conventional three dimensional conformal radiotherapy. Surgery was done at least 6 weeks after CCRTH.

Results

Thirty five patients with LARC were recruited during the period from December 2017 till January 2019. Five patients (20.8%) had a pathological complete response (TRG 0) (ypT0N0). Another three patients (12.5%) had near complete pathological response (TRG 1). While unfortunately 29.2% and 37.5% had partial response and poor response respectively.

Conclusion

Induction chemotherapy could be a promising option for better response rates either clinical or pathological for high risk LARC patients with acceptable toxicity profile.
Evaluation of the Effect of Combination Chemotherapy with Five-day Infusion of Fluorouracil Plus Vinorelbine in Pretreated Metastatic Breast Cancer Patients
Authors: Kamel Tarek , Din Mai Ezz El , Nagy Ahmed , Salah Rasha
Published: October 2021

Background

continuous infusion (CI) of 5-fluorouracil (5-FU) has proven in several studies to be an active and well tolerated treatment for advanced pretreated breast cancer. Navelbine has also shown activity in this setting.

Aim

This is retrospective study to evaluate the clinical activity and side effects of a combination chemotherapy consisting of a five-day continuous infusion of fluorouracil and i.v. vinorelbine in metastatic previously treated breast cancer patients.

Patients and Methods

Fifty-four patients received 5FU 600 mg/m2/d for 5 consecutive days as a continuous infusion and vinorelbine 25 mg/m2 on days 1 and 5 as a short intravenous (I/V) infusion every 3 weeks.

Results

Eleven (20.4%) complete responses, 20 (37%) partial responses and 14 (25.9%) stationary disease were documented, accounting for a clinical benefit rate of 83.3%. The median progression free survival was 6.8 months. The median overall survival was 25.8 months. Treatment was well tolerated, with Grade 3 anemia, febrile neutrobenia and stomatitis in 9.3%, 5.6% and 1.9% respectively as the main toxic reactions. Conclusions: This drug combination is active in metastatic previously treated breast cancer patients with acceptable toxicity profile.
Anterior Approach of Total Hip Arthroplasty, a Systematic Review
Authors: El-Helaly Haitham Abdel-Azem , Zakaria Zeiad M , Mohsen Ahmed Essmat Abdel
Published: October 2021

Background

There are 3 commonly used surgical approaches to the hip: the anterior, lateral [anterolateral (Hardinge) and direct lateral (Watson-Jones)].and posterior approaches. Each one is different from the other in anatomy, technical aspects, outcome and complications. However there is no current consensus regarding which approach is the most suitable.

Aim of the Work

To compare various clinical outcomes and complication rates across the 3 approaches focusing on direct anterior approach which may influence surgeon choice in the future and to identify which approach is the best for THA.

Patients and Methods

This systematic review and network meta-analysis were conducted following guidelines in the preferred reporting items for systematic reviews and meta-analyses (PRISMA), extension of network meta-analyses. The outcomes of interest were VAS, HHS and postoperative total complications after THA. Methods of measure for these outcomes were used according to the original studies.

Results

The lowest VAS pain and highest HHS after THA is the anterior approach followed by the lateral approach. The best approach class that had the lowest complications was posterior followed by the lateral approach, and the anterior approach had the highest risk of having complications after THA. Although the anterior approach had efficient postoperative outcomes, it should still be use with caution due to the high complication rates.

Conclusion

The best surgical approach for the lowest VAS pain and highest HHS after THA is the anterior approach followed by the lateral approach. The best approach class that had the lowest complications was posterior followed by the lateral approach, and the anterior approach had the highest risk of having complications after THA. Therefore, the use of the posterior approach is safe for THA, whereas although the anterior approach had efficient postoperative outcomes, it should still be use with caution due to the high complication rates.
Study the Results of Antibiotic Prophylactic Protocol Adopted by Ain Shams University Hospitals for reducing the Risk of Surgical Site Infection in Patients undergoing Hip Arthroplasty, Pilot Study
Authors: Zaher El Zaher Hassan El , Samir Shady , Khaled Ahmed Mohamed , Farrage Ahmed Mohamed Abdel Rahman Mohamed
Published: October 2021

Background

Total hip arthroplasties are well-proven solutions in case of end-stage osteoarthritis of the hip joint. Although, presence of complications can be devastating for the patient, especially periprosthetic joint infection (PJI). To prevent PJI, antibiotic prophylaxis regimens are regularly used.

Objectives

To study the association of antibiotic choice, duration and dosage with prevalence of surgical site infection among patients with hip arthroplasty and identify risk factors for surgical site infection in patient with hip arthroplasty.

Patients and Methods

After obtaining the hospitals Research/Ethics Committee approval and written informed consents from the patients, this study was carried on. 30 patients with primary hip arthroplasty surgery and all operations were performed by senior staff members. All patients were screened for suitability by detailed clinical assessment of their history and physical examination as well as radiological investigations.

Results

The result of this study was that we have 2 cases infected from 30 cases with percent of infection among patient with primary hip arthroplasty is 6.7% and by studying the risk factors for infection there was no specific risk factor for infection except for patient with cardiac disease have increased risk of infection.

Conclusion

In conclusion, this study postulated that systemic antibiotic prophylaxis delivered preoperatively in primary THA procedures significantly reduces the incidence of infection. There is no significant difference in the efficacy of cephalosporins compared with that of quinolones. Prophylactic antibiotics should be taken IV before skin incision by 30-60 minutes and no need for antibiotics more than 24 hours after operation.
Minimally Invasive versus Open Repair for the Treatment of Acute Achilles Tendon Rupture in Adults: A Prospective Randomized Controlled Study
Authors: Ghaly Nabil Abdel Moneam , Elbeltagy Atef Mohamed Fathy , Rahman Amr Farouk Abdel , Hamed Mahmoud Ahmed
Published: October 2021

BACKGROUND

The aim of this study is to compare open repair and minimally invasive repair in acute Achilles tendon rupture in adults regarding operative techniques, functional outcome and complications.

DESIGN

A prospective randomized controlled comparative trial.

METHODS

40 consecutive cases with acute complete Achilles tendon rupture were divided randomly in 2 equal groups (20 treated by open Krackow repair and 20 treated by minimally invasive repair with the PARS device), average age 41 years, follow up time was average of 7 months. Patients were assessed clinically and functional scoring system of postoperative American Orthopaedic Foot & Ankle Society ankle-hindfoot score (AOFAS) was used postoperatively.

RESULTS

Our results found that there were no significant differences between both groups in rates of postoperative complications (MIS group 10%, open repair group 15; P = 0.134). PARS group had greater postoperative AOFAS score, early rehabilitation, better cosmetic appearance and smaller scar length than open Krackow repair of acute Achilles tendon rupture.

CONCLUSIONS

We have found out that minimally invasive techniques such as the PARS are clinically and biomechanically suitable alternatives to open repair based on both clinical outcomes and repair strength.
Hip arthroplasty for failed internal fixation of intertrochanteric fractures: A Systematic Review and Meta-Analysis
Authors: Makram Milad Khair , Eid Ahmed Salem , Sallam Ahmed Mohamed
Published: October 2021

Background

hip replacement is a satisfactory salvage procedure for failed fracture treatment despite the increased operative difficulty.

Objectives

the purpose of this systematic review and meta-analysis was to review and study literature regarding conversion arthroplasty in patients with failed internal fixation of intertrochanteric fractures to evaluate the results, technical problems and complications, as well as the impact of different variable factors and age. associated with hip arthroplasty and to evaluate the functional outcomes and complications..

Materials and Methods

A systematic review of 3 databases (PubMed, Cochrane, and Embase) was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria were English-language studies that reported complications or functional outcomes after failed fixation of IT fractures with hip arthroplasty in adult subjects (>18 years of age).

Results

About 2041 articles were found using search keywords as shown in PRISMA flow chart, By filtration and screening of the title and exclusion of unrelated articles, about 109 articles were found, By applications of all inclusion and exclusion criteria, only 8 articles were fit to undergo this meta-analysis.

Conclusion

So this study showed a significant improvement in functional outcome of hip arthroplasty after failed intertrochanteric fixations despite the relative complication rate of this procedure.
Role of ultrasound guided injection of platelet rich plasma (PRP) in knee osteoarthritis patients
Authors: Mohamed Ahmed Emad Mahdy , Hassan Mohamed Sobhy , AbdelMotelib Mohamed Gamal Eldin
Published: October 2021

Background

Multiple promising researches were done regarding using platelet rich plasma (PRP) injection aiming at establishing new minimally invasive treatment option for knee OA and avoiding surgical procedures hazards which could be an option in advanced cases. Thus, our study will be directed towards ultrasound guided injecting of PRP trying to confirm the efficacy of the procedure as a therapeutic option.

Objective

The study aims to assess of the role of ultrasound guided PRP injection in cases of knee osteoarthritis and follow up of the symptoms outcome.

Methods and material

Twenty patients with different knee osteoarthritis grades were injected with PRP under ultrasound guidance and the symptoms outcome were followed up by using visual analogue scale (VAS), WOMAC osteoarthritis index, OXFORD knee score, LYSHOLM knee scoring scale at periods of , and weeks post procedure.

Results

A total of patients were included with the age ranging from - years old, the mean was . years old (SD ± . ). Among them patients ( ) were females and patients ( ) were males. There was statistically significant difference between the different knee pain scoring scales , and weeks after the procedure compared to before injection, where according to VAS score the mean score was . . pre procedure and became . . , . . and . . after , and weeks respectively with mean reduction ratio of . % after months. The extent of the difference over the periods through WOMAC in knee osteoarthritis patients was . . ,. . and . . after , and weeks respectively, compared to . . before the procedure with a mean reduction ratio of . % after months. While according to OXFORD knee score, the patient’s scores were . . before the procedure Vs . . , . . and . . at , and weeks after injection with symptoms mean reduction ratio of . %. According to LYSHOLM knee scoring scale, the mean score was . . pre procedure and became . . , . . and . . after , and weeks respectively with months mean reduction ratio of . %.

Conclusion

PRP injection in symptomatic knee osteoarthritis patients cause statistically significant improvement of the symptoms.
Corpus Callosum Microstructural Alterations In Children With Memory Related Learning Disability: A Diffusion Tensor Imaging Study
Authors: Abd elhameed Abeer Maghawry , Mohammad Shaimaa Abdelsattar , Nashaat Neveen Hassan , Abdel-Rahman Amgad Samy , Raouf Ehab Ragaa Abdol
Published: October 2021

Purpose

The purpose of this study is to assess the corpus callosum microstructural changes in children with memory related learning disability.

Methods

DTI was performed in 20 patients with memory related learning disabilities (MRLD +) and 22 matched healthy control subjects (MRLD -) aged 7– 13 years. Fractional anisotropy (FA), axial diffusivity, radial diffusivity (RD) and trace were calculated for corpus callosum. Comparison between patients with memory related learning disabilities (MRLD +) and healthy control subjects (MRLD -) was performed. DTI metrics were correlated to clinical digit span backward scores in (MRLD +) group. A pvalue less than .05 was considered significant.

Results

The corpus callosum showed a highly significant higher FA and lower diffusivity indices in (MRLD +) group compared to the (MRLD -) group (p < 0.001). No significant correlation between the clinical test “digit span backward” scores and DTI metrics of the corpus callosum was found.

Conclusion

Changes in DTI metrics of corpus callosum in patients with memory related learning disabilities reflects white matter micro-structural changes. Higher FA values and lower diffusivity indices do not necessarily indicate healthier white matter but, can indicate pathology.
CT of pelviabdominal masses in pediatrics: Diagnostic algorithm
Authors: Awwad Amina Osama Mohamed , Ahmed Hanan Eissa , Mohammed Shaimaa Abdelsattar
Published: October 2021

Background

Pelviabdominal masses are common in children. It can be a leadig cause of considerable morbidity and mortality.

Objective

To review the different pelviabdominal masses and their diagnostic criteria using the multidetector CT scans in order to build an approach for diagnosis.

Methods

A retrospective study, conducted at Ain Shams University hospitals on children complaining of pelviabdominal masses, the patients were investigated using CT scans in the period between June 2018 till end of May 2019.

Results

pelviabdominal CT scan of 70 patients were reviewed. Their age ranged from 7 days to 18 years old, the mean was 8 years of age (SD ± 5.5). 31 male : 39 female. Abdominal masses of pediatrics were congenital ( 9 case), neoplastic ( 20 cases), inflammatory ( 23 casaes) and post traumatic in origin (3 cases).

The most common congenital masses were PUJO, neoplastic were neuroblastomas, inflammatory were abscess.

Diagnostic approach should start with determination of the organ of origin followed by determination of its morphology and pattern of contrast enhancement.

The kidney was found to be the most common organ of origin in 25.7% of cases followed by the adenxa.

Conclusion

the organ of origin and morphology of the lesion are key imaging features that will help the radiologist reach a definitive diagnosis or deliver a possible differential diagnosis.
Improving the accuracy of contrast enema in diagnosis of Hirschsprung disease
Authors: Eskander Amir M , Mansour Hesham M , Ali Shehata Khaled A
Published: October 2021

Background

Hirschsprung’s disease (HD) is one of the most important causes of chronic constipation in children due to its possibly fatal Amir Maurice Eskander complications if left untreated. Contrast enema (CE) is the first investigation done to diagnose Hirschsprung’s disease as it’s the safest, least invasive, most widely available and least expensive as compared to anal manometry and rectal biopsy however it had shown a wide range of sensitivity and specificity in previous studies.

Aim of the work

to improve the accuracy of contrast enema by studying each possible abnormal finding related to Hirschsprung’s disease and calculating its sensitivity and specificity in comparison with biopsy, as a gold standard method to determine the most reliable signs to use for diagnosis.

Patients and Methods

This cross sectional study was carried at pediatric radiology unit Ain Shams university hospitals, starting from July 2018 to June 2019. 43 patients met all inclusion and exclusion criteria and were included in the study. Contrast enemas results and findings were compared to the patient’s final diagnosis. PPV, NPV, specificity, and sensitivity was calculated for each finding.

Results

Absence of rectal gas in the plain film, transitional zone, abnormal recto-sigmoid index, enlarged colonic caliber and delayed evacuation showed significant association with HD. Abnormal recto-sigmoid index was the most reliable sign in our study to diagnose HD having the highest sensitivity and specificity.

Conclusion

CE is an excellent initial investigation in HD and combining it with detailed history taking and clinical examination can lead to decrease in unnecessary rectal biopsies.
Thyroid Imaging Reporting And Data System (TIRADS) For Ultrasound Features Of Solitary Thyroid Nodules
Authors: Salah Amr Salama A , Abu-Gamrah Sherif H , Hussein Ahmed M , Nasser Haytham M
Published: October 2021

Purpose

to investigate the Thyroid Imaging Reporting and Data System (TIRADS) as a new classification system for solitary thyroid nodules by high resolution Ultrasonography in correlation with histopathological study.

Materials and Methods

Thirty patients with clinically suspected thyroid nodules referred to Radiology department at Ain shams University hospitals after fulfilling inclusion and exclusion criteria. All thyroid nodules are examined by ultrasound and charactrized according to internal components, margins, echogenicity, shape and evidence of echogenic foci the classified according to the American college of radiology (ACR) TIRADS guidline, then compared with histopathological examination by Fine needle aspiration cytology (FNAC) .

Results

Many ultrasound features were predeictors of malignancy hypoechoic echopattern, taller than wider shape, punctate echogenic foci, and lobulated and irregular margins with (p < 0.05). Risk of malignancy on TIRADS 1 and 2 nodules were 0%, also on TIRADS 3 nodules was 0%. While on TIRADS 4 and 5 nodules were 11.1% and 88.9% respectively. ROC analysis revealed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under curve (AUC) are 100, 85.71, 75.00, 100.00 and 0.987 respectively when using cut-off value of score <5.

Conclusion

Our results suggest that ACR TIRADS classification is reliable in predicting thyroid malignancy. It could lead to a significant decrease of the number of unnecessary FNAC.
Comparison between manual and automated CT liver volumetry in assessment of the liver volume in living donor liver transplantation
Authors: Kamal Omina Ahmed , Azab Enas Ahmed , Mahmoud Ahmed Abdelsamie , Abdeldayem Emad Hamid , Taha Eslam Mahmoud
Published: October 2021

Aim of the work

To evaluate the effectiveness and advantages of automated CT volumetry in the assessment of liver volume in living donor liver transplantation and to compare this technique and its results with those calculated from manual volumetry.

Materials and Methods

This comparative study was conducted on dynamic contrast enhanced hepatic CT scans of 21 potential living liver donors. All potential donors underwent 1st step laboratory investigations to enter the 2nd step investigations for living donor liver transplantation operation. Automated liver volumetry was developed using the Myrian® XP-Liver software. To establish reference standard liver volumes, a radiologist manually traced the contour of the liver on each CT slice. We compared the results obtained with automated with those obtained with the reference standard for this study, manual volumetry.

Results

The study showed that automated CT liver volumetry achieved excellent agreement with manual volumetry without statistical significance. The average processing times for automated volumetry was 3.09 ± 0.44 min/case, whereas those for manual volumetry were 16.23 ± 0.81 min/case, the difference was statistically significant (p < 0.05).

Conclusion

Automated CT liver volumetry performed using the Myrian® XP-Liver software can accurately predict the preoperative liver volume and provide acceptable measurements comparable to the gold standard manual volumetry.