bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Planned Surgical versus Percutaneous Access Vascular Outcomes and Complications in Patients Undergoing Transcatheter Aortic Valve Implantation
Authors: Abdelshahid Remon R , Kamal Diaa , Mostafa Ahmad E , Sadek Yasser
Published: August 2023

Background

Increased expertise and technical advancements lead to a significant reduction of major access site-related vascular complications that occur, nowadays Post and intra-procedural in < 10% of cases. Due to its wide diffusion and feasibility, the trans-femoral access is the preferred route in the majority of the clinical trials and is recommended as first choice by all guidelines and consensus documents, as vascular complications are a non-comparable factor to traditional SAVR so it is a new side effect that has emerged with TAVI that is in need to be minimized.

Aim

The aim of this work is to compare surgical versus percutaneous access peripheral vascular outcomes in TAVI procedure during hospital stay.

Patients and Methods

This was a Comparative cross-sectional study that was conducted at Ain Shams university hospitals & Helwan university hospital this study included 68 retrospective and prospective patients that were scheduled for TAVI 29 with percutaneous access followed by device closure (Proglide) and 37 surgical cut-down patients followed by surgical closure.

Result

A total of 68 patients were enrolled, 34 patients were females (50 %) and 34 patients were males (50 %). Their age ranged from 65-97 years with mean age (75.12) years. Patients in this study are classified into 2 groups: Group I: included patients who did the procedure with percutaneous vascular approach followed by device closure. Group II: included patients included patients who did the procedure with surgical cutdown vascular approach.

Conclusion

There is no significant difference in vascular complications between the 2 approaches indicating that whenever closure devices (Proglide) are available it can be used safely on patients undergoing TAVI, a more dedicated closure device to larger puncture sites such as MANTA should be properly studied as a promising step.

Recommendation

Larger studies with increased sample size are recommended for proper evaluation of intra and post procedural predictors of vascular complications. Further studies on the new MANTA device as it is a dedicated device to larger puncture sites. Long-term follow up.
Frequency and Risk Factors of Difficult-to-Control Asthma among Patients
Authors: Zidan Amal Ibrahim Abd Elhamid , Faramawy Mohammed Abd Elsabour , Dewidar Ibrahim Ali
Published: August 2023

Background

Difficult-to-control asthma (DTA) is associated with significant medical and financial burden. Difficult-to-treat asthma is asthma that is uncontrolled despite Global Initiative for Asthma (GINA) Step 4 or 5 treatment (e.g. medium or high dose inhaled corticosteroids (ICS) with a second controller; maintenance OCS), or that requires such treatment to maintain good symptom control and reduce the risk of exacerbations

Objectives

to assess causes and possible precipitating factors for difficult-tocontrol asthma in Kafr Elsheikh Chest Hospital.

Patients and Methods

This prospective cohort study enrolled 40 adult with DTA who were followed for 12 weeks. At the start, patients who had scores suggestive of DTA by using asthma control test (ACT) and questionnaire(ACQ) were enrolled. Spirometry was done at the start and adherence was ensured then spirometry was done again to eliminate possibility of non-adherence as a cause of uncontrolled asthma. ACQ and ACT were reassessed to classify patients.

Result

Male: female ratio was 1:1. Age ranged from 18.0 to 74.0 years. After twelve weeks, difficult-to-control asthma still present in 27.5%. There is statistically significant relation between DTA and all of family history of asthma, gastroesophageal reflux (GERD), allergic rhinitis/sinusitis, duration of asthma. On multivariate analysis, GERD, positive family history, comorbid allergic rhinitis, associated allergies and disease duration≥10 years increase risk of DTA by 4.56, 12.94, 1.389, 13.74 and 14.733 folds respectively.

Conclusion

GERD, positive family history, presence of allergic rhinitis, associated allergies and disease duration≥10 years were independent risk factors for DTA.
Retrospective Study for TB Cases in Kafr El-Shiekh from January 2010 to January 2019 and Role of GeneXpert in Diagnosis
Authors: ELbouhy M S , Ali E R , Elmesery Aml Yossif
Published: August 2023

Background

Tuberculosis (TB) is a major health problem. Mycobacterium tuberculosis (MTB) is one of the top ten causes of death and the leading cause from a single infectious agent (above HIV/AIDS) Worldwide. Each year millions of people continue to fall sick with.

Aim of the Study

The aim of this study was to find out tuberculosis pattern in Kafr EL-Shiekh Governorate during the period between January 2010 and January 2019 and role of GeneXpert in diagnosis of TB.

Methods

This retrospective study was carried out using medical records from the TB registry in Kafr EL-Shiekh Chest Hospital. The investigated variables included demographic characteristics, type of TB infection, and affected organs. All data were coded and statistically analyzed.

Results

through study period 1189 cases were recorded 82.5% of them were pulmonary TB and extrapulmonary founded in 17.5% cases. The mean age was 36.42 years and there was male predominance 57.4%, female was 42.6%, higher number of cases were reported in 2013. Tuberclin test was positive in 99.2% of cases and negative in 0.8% of cases and sputum positive in 74.2% of cases and negative in 25.8% of cases. Cases with sputum positive 96.9% had positive Z_N. stain, 98.2% positive culture and Gene expert positive in 27.6% of cases. 87.2% of cases treatment completed and treatment failure in 12.8%. sensitivity, PPV, NPV and accuracy of gene expert in diagnosing pulmonary TB cases founded to be 98.19%, 86.86%, 85.49% respectively, sensitivity, specificity, PPV, NPV and accuracy of gene expert in diagnosing extra pulmonary TB cases founded to be 100%, 1.81%, 13.14%, 14.51% respectively.

Conclusion

TB affects the most productive age groups and this necessitates more attention in TB control programs targeting those age groups. Our findings suggest GeneXpert as a sensitive and specific powerful diagnostic method in patients of suspected pulmonary tuberculosis either AFB smear negative or positive due to its rapidity
Study of Addiction in COPD Patients in Abbassia Chest Hospital
Authors: Saeed Adel Mohamad , Raafat Riham Hazem , Muneer Mahmoud M
Published: August 2023

Background and objectives

Chronic obstructive pulmonary disease (COPD) is multi-factorial systemic disease that commonly associated with tobacco smoking, moreover, smoking cannabis substance become widely used. The aim of the study is determining the pattern of addiction pattern in patients with COPD, in addition to evaluating the impact of that substance in the disease course.

Methods

About 100 male patients with definite COPD diagnosis and history of regular substance abuse were enrolled in the study, all of them subjected to COPD assessment test (CAT) and addiction questionnaire.

Results

The mean age of the studied patients was (52.84 ± 10.21) years, and 15 % of them with overweight. Addiction with Hashish (cannabis) was the most prevalent among the studied groups (70%), while 3 and 2% of cases had used IV substance and Heroin respectively. The most predominant CAT score category were CAT score III and IV with frequency about 44% and 30% respectively. More than half of cases (52%) admitted to ICU because of substance abuse two times or more during the duration of the study.

Conclusion

The prevalence of Hashish (Cannabis) addiction was higher among COPD patients, and significantly associated with higher CAT score category, in addition to increase the frequency of repeated ICU admission with respiratory complication.
Serum Erythroferrone in End Stage Renal Disease Patients: Relation to Iron Status, Anaemia and Erythropoiesis Stimulating Agents
Authors: Abdelghany Aya-tAllah Mohamad , Mohamed Amal Abd-El-Hamid , Hebah Hayam Ahmed , Salem Dalia Diaa ElDine
Published: August 2023

Background

Anaemia is a hallmark of chronic kidney disease (CKD), where erythropoietin deficiency and reduced iron availability by the negative iron regulator, hepcidin, are principal causes of the anaemia. Erythroferrone (ERFE), a hormone synthesized by erythroblasts, is a hepcidin inhibitor and increases iron absorption and mobilization, resulting in erythropoiesis stimulation. Thus, ERFE could be considered as one of potential clinical biomarkers for assessing erythropoiesis. Moreover, it has been found that ERFE is produced in response to erythropoietic stimulating agent (ESA) in CKD and thus could have a role in cure from anaemia in those patients. However, few studies focused on understanding the role of this hormone in the regulation of iron homeostasis.

Aim of the Work

To study the correlation between ERFE level and iron parameters and its response to iron/ESA in end stage renal disease (ESRD) patients with iron deficiency anaemia.

Study design and methods

A case-control study was carried out on 40 ESRD patients (GFR < 15 ml/min/1.73 mm3) with evidence of iron deficiency anaemia. Patients were further subdivided into 2 subgroups, where subgroup I included patients who received both iron and ESA (Erythropoietin) (n = 28) and subgroup II patients who were treated with iron only (n = 12). Ten age & sex matched normal healthy subjects were included in the study as a control group. The studied parameters (ERFE, Hb, HCT%, MCV, MCH, serum iron, TSAT% and TIBC) were measured at baseline and then revaluated three months later after iron/ESA therapy. Erythroferrone was measured (baseline and post iron/ESA treatment) by ELISA.

Results

The present study was conducted on 40 ESRD patients with male to female ratio 1:1.5. Their mean age was 51.03±11.22 years and mean dry weight 73.4±13.08 Kg. The commonest risk factor was hypertension (32.5%). Treatment with iron ± EPO results in significant increase of Hb and serum iron in both patients' subgroups (p ˂ 0.001). Baseline and post treatment ERFE levels were higher in patients’ groups than in the control group with significant statistical difference (p = 0.016 & 0.023 respectively). The highest level was in those patients treated with both iron and EPO (212.31±106.33 ng/L at baseline & 520.00±255.26 post treatment). Positive correlation of ERFE level with both Hb and serum Iron (p-value <0.05) was detected.

Conclusion

Managing anaemia in ESRD patients remain a significant unmet challenge in those patients. Insight into iron homeostasis is important in order to develop new diagnostic as well as therapeutic modalities. Our study proved that ERFE is associated with iron/EPO therapy and positively correlated with hemoglobin and serum iron levels. Thus, ERFE could play a key role in the assessment of erythropoietic activity, as well as, in the treatment process among those patients in status of iron deficiency or iron overload.
ADAMTS13 and Von Willebrand Factor Levels in Patients with Chronic hepatitis C: Relations to Hemostatic Imbalance and Bacterial Infection
Authors: Wahba Mona A , El-Bassiouni Nora E , Elsakhawy Yasmin N , Zahran Nariman A , Attoa Hend G
Published: August 2023

Background

Liver cirrhosis is in close association with bacterial translocation as a result of alteration of intestinal barrier. In response to inflammation, the endothelial cells release the content of WPBs, VWF in the extracellular portion.

The aim of the study was to assess the levels of ADAMTS13 and their impact on the prothrombotic function of VWF in patients with chronic hepatitis C with or without SBP.

Patients and methods

75 individuals were the study population, 60 patients with CLD classified into: Child A (n = 15), Child B (n = 15) and Child C (n = 30) the latter is further classified into Child C (n = 15) and Child C patients with SBP (n = 15); healthy controls (n = 15). This study was performed at Theodor Bilharz Research Institute (TBRI), Imbaba, Giza. Determination of CRP by fixed time nephelometry. Determination of LBP, VWF, ADAMTS13 and D-dimer by magnetic multiplexed flowcytometry based immunoassay Luminex®.

Results

VWF levels were significantly increased (p < 0.01) in different groups of patients with CLD compared to controls. A similar significant increase (p < 0.01) was also noticed in Child C patients with SBP compared to other study groups. ADAMTS13 antigen levels were significantly decreased (p < 0.01) in different groups of patients with CLD compared to controls. D-dimer levels were significantly increased (p < 0.01) in different groups of patients with CLD compared to controls.

Conclusion

The levels of VWF correlated with the systemic inflammatory and bacterial translocation markers. ADAMTS13 levels were decreased in cases of systemic inflammatory process that accompanies SBP, leading to increased VWF levels.
Serum Calprotectin as a Potentially Sensitive Biomarker for Inflammatory Bowel Disease in Egyptian Patients
Authors: Azab Nehal , Talkhan Hala , Samaha Dalia , Salem Lamyaa
Published: August 2023

Background

Inflammatory bowel disease (IBD) incidence is increasing nowadays. Its diagnosis depends on invasive techniques such as colonoscopy and biopsy which is the gold standard for diagnosis. Its activity is monitored by fecal calprotectin levels which has a low compliance rate. Although it is unlikely for serum biomarkers to replace colonoscopy, a need exists for a serum biomarker that at least decreases the need for such an invasive technique.

Aim of the Work

The aim of this work was to evaluate serum calprotectin as a biomarker for IBD in Egyptian patients.

Patients and Methods

The study was conducted on 50 Egyptian IBD patients, 34% were males and 66% were females with their ages ranging from 15 to 62 years. Based on IBD type 60% were diagnosed as ulcerative colitis (UC) half of them were in clinical activity and the other half in remission and 40% were diagnosed as Chron’s disease (CD) half of them were in clinical activity and the other half in remission. IBD patients were recruited from Gastroenterology Clinic, Ain Shams University Hospitals in the period from October 2019 till October 2020. In addition, 20 race-, sex- and age- matched apparently healthy subjects were included in the study as a control group. Serum calprotectin levels were measured by ELISA.

Results

The results revealed that the serum levels of calprotectin were significantly higher in IBD patients than in the control group and in clinically active patients than those in remission. There was a positive correlation between serum calprotectin levels, CRP and ESR, however the diagnostic value of serum calprotectin was higher than that of CRP and ESR as serum calprotectin had higher sensitivity and specificity. The specificity of serum calprotectin in diagnosing IBD was 95% and the sensitivity was 98%; the specificity of CRP was 85% and the sensitivity was 64%; the specificity of ESR was 85% and the sensitivity was 62%. Our work revealed that there was a direct relationship between serum calprotectin and platelet count and an inverse relationship between serum calprotectin and albumin and hemoglobin levels.

Conclusion

Serum levels of calprotectin are increased and are associated with clinical activity in IBD patients so it may become one of the clinically valuable indicators of activity of the disease.
The Relationship between Single Nucleotide Polymorphism of ERCC1 Gene and the Response to Platinum Based Chemotherapy in Egyptian Non-Small Cell Lung Cancer Patients
Authors: Abd el-Mageed Abeer Ibrahim , El-Din Manal Mohsen M Kamal , Zaghla Heba M Adel Abou , Abdelhakam Dina Abdelmoneim Mahmoud , Ahmed Rana Ehab Moustafa
Published: August 2023

Background

Lung cancer (LC) is the second most common cancer diagnosed in both males and females. There are two subtypes of LC. Non-small cell lung cancer (NSCLC) is the major one. Treatment options for NSCLC depends mainly on the stage at diagnosis. The majority of the patients are diagnosed at advanced stages at time of presentation. Therefore, chemotherapy and radiotherapy play the dominant role in treatment of advanced NSCLC. The most commonly used chemotherapy is platinum-based chemotherapy as cisplatin and carboplatin and third generation drugs as vinorelbine and gemcitabine. The efficacy of platinum-based chemotherapy is limited by chemoresistance. The excision repair cross complementation group 1(ERCC1) gene is a member of nucleotide excision repair pathway that plays a critical role in the DNA repair by removing DNA covalent helix-distorting adducts.

Aim of the Work

In this study investigated the relationship between single nucleotide polymorphism of ERCC1 rs11615 and the response to platinum-based chemotherapy in Egyptian NSCLC patients in order to prevent the non-necessary exposure to the toxic effect of chemotherapy.

Patients and Methods

This is a cross-sectional study conducted on 50 NSCLC patients who were recruited from the Oncology Clinic in Ain Shams University Hospitals; twenty of them were responders to platinumbased chemotherapy and the other 30 were non-responders according to RECIST criteria. All subjects underwent full medical history focusing on tobacco smoking and family history of cancers, thorough clinical examination, histological diagnosis of NSCLC and TNM classification, radiological studies: computed tomography of chest and abdomen and laboratory investigations in the form of: complete blood picture (CBC), liver function tests and kidney function tests. Detection of the ERCC1 (T/C) polymorphism by realtime PCR was done for both the responders' and the non-responders' groups.

Results

There was no significant statistical difference observed between the responders’ and nonresponders’ groups regarding the genotype frequencies nor the allelic frequency (p > 0.05).

Conclusion

The present study did not confirm the presence of significant association between the genotypic frequencies nor the allelic frequencies of the ERCC1 rs 11615 among the responders' and the non-responders' groups. Further studies with higher sample size are needed to clarify the association.
Assessment of the Serum High-Mobility Group Box 1 Level in Vitiligo Patients in Comparison to Healthy Subjects and Its Relation to Total Oxidant Status and Disease Activity
Authors: Fakkar Nehal Mohamed Zuel , Soltan Marwa Yassin Ahmed , Roble Abdulkadir Aweis Ahmed
Published: August 2023

Background

Vitiligo is an acquired pigmentary disorder of unknown etiology, affecting approximately 1% of the world population, without predilection for race or sex. It is characterized by white macules and patches, whose size increases over time, due to the loss of melanocytes.

Aim of Work

The aim of work was to evaluate the serum level of high-mobility group box 1 in vitiligo patients and its relation to total oxidant status levels and disease activity.

Subjects and methods

This is a cross-sectional study which was carried out on 48 patients diagnosed as having vitiligo (24 active patients and 24 and non active) and 48 health controls for 6 months duration. All patients were selected from the dermatology outpatient clinic of vitiligo, Ain-Shams University Hospitals.

Results

The serum levels of HMGB1 among patients and controls revealed that patients had a statistically high significant levels of HMGB1 (p value 0.001), HMGB1 serum levels in vitiligo patients were significantly positively correlated to TOS serum levels and VIDA score (p value 0.001), between active and non-active group, there was a highly statistical significant difference between the two groups regarding serum level of HMGB1, as the serum HMGB1 levels were much higher in active compared to non-active patients (p value 0.001).

Conclusion

HMGB1 is a crucial damage associated molecular pattern molecule that links oxidative stresses to the formation of autoimmunity in the pathogenesis of vitiligo. HMGB1 is a crucial inflammatory factor involved in the progression of vitiligo. Serum HMGB1 level is a promising biomarker for monitoring disease activity in patients with vitiligo. HMGB1 may be a promising therapeutic target for the treatment of vitiligo.
Evaluation of Granulysin Level in Active Vitiligo
Authors: Mohammed Ghada Fathy , Elhusseiny Rania Mahmoud , Alkhateeb Asmaa Harith Mustafa
Published: August 2023

Background

Vitiligo is an acquired, a progressive, multifactorial, depigmenting disorder characterized by the appearance of circumscribed white macules in the skin due to chronic, progressive loss of functional melanocytes in the epidermis.

Aim of the Work

We aimed to evaluate GNLY- levels in stable and active vitiligo patients in comparison to healthy controls.

Patients and Methods

A case-control study which was carried out on 66 subjects: 22 patients with active vitiligo, 22 with stable vitiligo, and 22 age and sex-matched controls. All patients were recruited from the Dermatology Outpatient Clinic of Ain Shams University hospitals during the period from February 2021 to May 2021.

Results

We found a statistically significant difference between vitiligo patients and controls regarding GNLY levels with higher GNLY-levels among cases as compared to control. There were no statistically significant relations between GNLY-levels and gender or age of patients, family history, distribution or duration of vitiligo as well as activity or severity of vitiligo disease. This suggests that GNLY has an important role in vitiligo pathogenesis regardless of the activity, severity, and different disease characteristics. To the best of our knowledge, our study was the first study that measured GNLY-level in vitiligo patients and compare it with controls. Also, compared GNLY level in stable vitiligo versus active vitiligo.

Conclusion

Our findings supported the possible role of GNLY in the pathogenesis of vitiligo. However, measurement of GNLY level can not be used as a discriminating marker between stable and active vitiligo.
Comparative Study of Polydioxanone Monofilament (PDO) Threads Combined with Scar Subcision versus Fractional CO2 Laser Combined with Scar Subcision in Management of Atrophic Post Acne Scars
Authors: Kahky Hanan El , Soltan Marwa Yassin Ahmed , Mahmoud Mostafa Mohamed Khalaf
Published: August 2023

Background

Acne is an inflammatory disorder of the pilosebaceous unit characterized by comedones, inflammatory papules, pustules, and nodules of the face, chest, and back. The inflammatory response in some acne patients results in permanent, disfiguring scars from either increased tissue formation or due to loss or damage of tissue. Many treatments have been attempted in order to improve acne scarring such as: chemical peels, surgical excision, subcision, punch grafting, dermabrasion, fillers and laser have been used to ameliorate atrophic acne scars with varying degrees of success

Objectives

The aim of this work was to study the efficacy of polydioxanone (PDO) monofilament threads combined with scar subcision versus fractional Co2 laser combined with scar subcision in management of atrophic acne scars.

Patients and Methods

This is a split-face pilot study included 10 patients with atrophic acne scars. The patients recruited from the Outpatient Dermatology Clinic at Ain Shams University Hospitals. Fractional CO2 laser sessions were done for the right side of the face (2 sessions - one month apart), and Polydioxanone (PDO) threads were inserted to the left side of the face (2 sessions - one month apart), each treatment modality was preceded by scar subcision. The patients were followed up for 3 months. The response of treatment was evaluated by Antera 3D camera.

Results

Our study revealed that treatment of the right side of the face with fractional CO2 Laser led to statistically significant improvement more than what was achieved by PDO threads on the left side. It was also found that both PDO monofilament threads and Fractional Co2 laser improved the skin texture.

Conclusion

.The current study confirmed the superiority of fractional CO2 laser for the management of atrophic post acne scars. Polydioxanone threads had an effect in improving the skin texture but their overall effect is not comparable to the effect of fractional CO2 laser. To the best of our knowledge, we were the first to compare between Fractional Co2 laser and poydioxanone threads regarding there efficacy in management of atrophic acne scars and to evaluate the response using Antera 3D camera.
Comparative Study of Intralesional Measles–Mumps–Rubella Vaccine versus Needling-Induced Autoinoculation in the Management of Genital Warts
Authors: Mohamed Nourhan Gamal , Zu El-fakkar Nehal , El-Khateeb Ekramy Ahmed
Published: August 2023

Background

Genital warts caused by human papillomavirus (HPV) are one of the most common sexually transmitted infections, especially among women. Genital HPV infection has a relatively long incubation period up to 8 months. It is known to have a high recurrence rate, and the infection by certain high-risk HPV strains is known to be associated with malignancies of cervix, penis, vulva, vagina, and anus. Thus, factors such as long latency, lesions’ multiplicity, high recurrence rate, and the tendency to malignant transformation, are essential challenges during management of genital HPV infections. The clinical outcome of traditional treatment modalities; such as podophyllotoxin, imiquimod, cryotherapy, electrocautery, trichloroacetic acid, photodynamic therapy, and laser, is limited to individual lesions. Therefore, they are usually inconvenient for patients with multiple and/or recurrent lesions.

Aim of the Work

to evaluate the safety and efficacy of intralesional injection of MMR vaccine in comparison with needling-induced autoinoculation in the treatment of genital warts.

Patients and Methods

Our study included 50 patients with multiple and recurrent genital warts (more than 4 genital warts) divided into two equal matched groups. One group was subjected to MMR injection and the other subjected to needling-induced autoinoculation every two weeks for maximum three sessions. Follow-up was done for 8 weeks after last session.

Results

This study reports that both treatment options showed statistically significant value in treatment of genital warts, and here was no statistically significant difference between both study groups as regard response to treatment.

Conclusion

both MMR and needling are simple and effective modalities of immunotherapy for treatment of multiple genital warts with excellent safety profile. The only disadvantage is the long time taken for immune response to occur. Combination treatment plan can overcome this disadvantage. Needling-induced autoinoculation; being more safe and inexpensive, may be considered as a competing immunotherapeutic treatment modality for multiple and recurrent genital warts.
Evaluation of the Efficacy of Nanofat Injection in Treatment of Androgenic Alopecia
Authors: El Kahky Hanan Mohamed , Seoudy Wael Mohamed , Elhusseiny Rania Mahmoud , Nazmy Yara Amr Ahmed
Published: August 2023

Background

Androgenic alopecia is the most common hair loss disorder in both males and females. The importance of this disease comes from the immense emotional distress that it leaves on the patient caused by the hair loss. The terminal hair follicles over the frontal and vertex regions are replaced by miniaturized hair follicles which leads progressively to a visible reduction in hair density.

Aim of the Work

To evaluate the efficacy of Nanofat injected into the scalp for management of androgenic alopecia.

Patients and Methods

This prospective clinical pilot study included 20 patients with androgenic alopecia, 10 males and 10 females, attending Dermatology outpatient clinic of Ain Shams University Hospitals from December 2020 to July 2021.

Results

Our results showed clinically significant improvement by comparing patients’ photographs in most of the treated patients and high mean patients’ satisfaction with minor encountered side effects. Moreover, dermoscope revealed significant increased median terminal hair density in all patients 6 months after nanofat session.

Conclusion

Although the exact mechanism of action is still unclear, nanofat injection can be considered an effective treatment modality for androgenic alopecia. Yet, further studies are needed with a bigger number of cases to minimize statistical errors and to detect the most accurate nanofat isolation method yielding best results.
Language Assessment in Children with Stuttering
Authors: Ibrahim Eman A , Elrefaie Dina A , Hassan Sabah M
Published: August 2023

Background

The incidence rate of stuttering is 5% among preschool children and about 1% among adults. Although the cause of stuttering has not been identified, a multifactorial hypothesis of stuttering has gained acceptance.

Aim of the Work

To evaluate and to assess language in children with stuttering.

Patients and Methods

This analytical (observational) cross sectional study was carried out at the outpatient clinic of Phoniatrics unit, ENT department, Ain Shams University Hospitals, included 30 children with stuttering as a case group, in addition to 30 healthy age and sex matched controls. Each child in the studied group was subjected to the protocol of assessment of fluency disorders (Kotby et al., 2015).

Results

In the current study, there was no statistically significant difference in the severity of stuttering between boys and girls with stuttering included in the current study. There was high statistically significant difference between the studied two groups regarding phonology and syntax. There was a statistically significant strong positive correlation between chronological age with receptive language age (p < 0.001), expressive language age and total language age (p < 0.001). There was a statistically significant strong positive correlation between receptive language age and expressive language age and total language age (p < 0.001).

Conclusion

Language is markedly affected among stuttering children in comparison to healthy control group.

Recommendation

Early diagnosis and assessment of stuttering is essential for proper intervention before language and behavioral deterioration.
Role of Hyperbaric Oxygen in Treatment of Invasive Fungal Sinusitis
Authors: Fawaz Samia Ahmed , Salim Hager Youssef , Shafek Michael Rezk
Published: August 2023

Background

Invasive fungal infections are a major cause of morbidity and mortality in immunodeficient individuals (such as AIDS patients) and in transplant recipients or tumor patients undergoing immunosuppressive chemotherapy. The most widely accepted therapy is the multimodal approach of using intravenous (IV) anti-fungal therapy in combination with sinus debridement, and hyperbaric oxygen (HBO) for the management of invasive fungal sinusitis.

HBO has an important role in management of those patients; there is a significant survival benefit with adjunctive HBO use, as HBO has a fungistatic effect, decrease growth rate of fungus, and decrease the morbidity.

Objective

to assess the use of Hyperbaric oxygen in treatment of invasive fungal sinusitis and evaluate its efficacy as HBO has a fungistatic effect, decrease growth rate of fungus, and decrease the morbidity.

Patients and Methods

The pertinent role of hyperbaric oxygen therapy in treatment of invasive fungal sinusitis has been popularized over the past decade, to approve the important role of HBOT we established our systematic review which include 15 studies and 98 patients.

Results

We assess the beneficial effect of adding HBOT in the protocol treatment of invasive fungal rhinosinusitis, which illustrate the favorable results supporting adding HBOT, as survival rate among patients treated with HBOT 66% against 42% survival rate among patients treated without HBOT.

Conclusion

Hyperbaric oxygen therapy is an attractive option in treatment of invasive fungal rhinosiusitis as an adjunctive therapy.
Evaluation of Central Auditory Processing in Individuals with Occupational Noise exposure
Authors: Tawfik Somia , Hassan Dalia Mohamed , Mahmoud Nermeen Mohy El-Din
Published: August 2023

Background

Prolonged exposure to high levels of occupational noise can cause damage to hair cells in the cochlea and result in permanent noise-induced cochlear hearing loss. Consequences of cochlear hearing loss on speech perception and psychophysical central auditory abilities have been well documented.

Objectives

the aim of this research was to explore central auditory processing in individuals with history of occupational noise exposure.

Subjects and method

sixty subjects aged between 20 and 50 years divided into 2 groups; control group (thirty normal healthy subjects), study group (thirty subject with history of occupational noise exposure). They were subjected to Basic audiological evaluation :Pure tone audiometry for frequencies 250-8000 Hz for air conduction and 500-4000 Hz for bone conduction, Speech reception threshold (SRT) using Arabic spondee words list (Soliman et al., 1985) and speech discrimination scores using Arabic phonetically balanced words (Soliman, 1976). And Tympanometry, central auditory processing questionnaire and Psychophysical central auditory tests that will be discussed later.

Results

Statistically significant difference was found between the study group and control group regarding left Dichotic digits test versionII (p = 0.020), The mean of SPIN either at Right or Left ear for study group was depressed in comparison to normal individuals, those differences were statistically highly significant (p < 0.001).

Furthermore, there was a Highly statically significant difference in TCST (30%,60%), GIN test and DPT between study and control groups (p < 0.001) either at Right or Left ear.

Conclusions

Patients with occupational noise exposure had poor performance in all central auditory tests when compared with control. This means that occupational noise exposure can lead to impaired central auditory processing with subsequent in adults
Comparison between Tonsillectomy by Coblation, Bipolar and Surgical Dissection
Authors: El Halabi Hisham Salah El-Din , Begermy Marwa Mohamed El , Mikahail Peter Milad , Saad Mostafa Sara
Published: August 2023

Background

Tonsillectomy is one of the most common paediatric surgical procedures performed worldwide. Although it is one of the most widely performed procedures in otorhinolaryngology, none of the commonly used techniques for tonsillectomy is considered optimal till now.

Objective

To compare coblation, bipolar diathermy, and surgical dissection approaches for tonsillectomy in terms of operative time, surgical blood loss, postoperative pain and the incidence of postoperative complications.

Methods

A systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. Guidelines and an electronic search of information was conducted to identify studies that compare between coblation, cold dissection and bipolar diathermy techniques.

Results

This study showed that bipolar diathermy tonsillectomy was the lowest risk of primary bleeding followed by coblation then cold dissection tonsillectomy but with insignificant difference. Coblation technique was the highest secondary bleeding risk followed by cold dissection and the lowest risk was figured in bipolar diathermy procedure also the difference did not reach statistical significance. Coblation tonsillectomy was the best technique regarding blood loss and operative time with significant difference in the comparison with cold dissection and insignificant in the comparison with bipolar diathermy. Because of using a different postoperative pain measures in the studies we could not pool its data, but the majority of studies showed that coblation technique was better as regard postoperative pain than cold dissection and bipolar diathermy. While there was no significant difference between cold dissection and bipolar diathermy in the most studies

Conclusion

Overall, bipolar diathermy procedure for tonsillectomy was considered the best technique regarding primary and secondary bleeding outcomes, but the difference did not reach statistical significance. Coblation procedure for tonsillectomy was considered the best technique regarding intraoperative blood loss with significant difference except in comparison between bipolar diathermy and coblation the difference was not significant. Coblation technique also considered the best one regarding operative time with significant difference in direct comparison between coblation and cold, and insignificant in other comparisons. By systematic review on 21 studies coblation technique shows less postoperative pain than cold dissection and bipolar diathermy in the majority of studies comparing coblation with every technique. And there was no significant difference between studies compared cold dissection with bipolar diathermy regarding postoperative pain.
Tympanoplasty in Pediatric Age Group: Meta Analysis Study
Authors: Baghdady Zainab Ashraf , Ibrahim Samer Ahmed , Abdelrazek Amr Nabil , Teaima Ahmed Abdelmoneim
Published: August 2023

Objectives

To evaluate the success rate and audiological results of pediatric tympanoplasty

Methods

Metanalysis study of articles involving of pediatric patients who underwent myringoplasty between the years 1995 to 2019, in Medline, Cochrane database. Anatomical and functional success were evaluated also ABG improvement. The influence of age on tympanic membrane closure were examined, publication bias was assessed and pooling of estimates were expressed. Our study consisted of 31 studies done on 2546 patients, with a mean age 10 years, DerSimonian-laird random effects and Forest plots were used for analysis.

Results

The anatomical success and the functional were 87% and 77% respectively. With the increase of age by 1 year the increase in functional success and anatomical success was 1% and 0.1% respectively also the ABG improvement around 0.2648 db.

Conclusion

Pediatric myringoplasty is associated with high rate of success, with a high rate of hearing improvement. Age under 7 is associated with less success.
Body Mass Index and Nutritional Intake among Primary School Children in Urban Area, Egypt
Authors: Mohamed Maha Hassan , Razek Suzan Abd El , Gabal Hebat Allah M S , Salama Maha Mohsen
Published: August 2023

Introduction

Primary school children are more vulnerable to malnutrition; underweight or obesity. Continuous nutritional assessment of the vulnerable groups is very important for the evaluation of current health status, besides future planning for prevention and control programs.

Aim of the Work

To assess the nutritional status and body mass index among primary school children attending primary healthcare centre in 10th of Ramadan city, El Sharqia Governorate, Egypt, and to identify different demographic factors that can affect nutritional status among them.

Materials and Methods

A cross-sectional study was conducted among 60 randomly selected primary school children. An interview questionnaire was used to collect data including demographic characteristics, family history of obesity, food intake using food frequency formula and the pyramid of food servings. Anthropometric characteristics including weight, height and BMI was estimated.

Results

The age ranged (6-12) for males and (6-9) for females, the mean was 8.62 and SD was 1.69. The mean height and weight of studied children were 127.33 ± 11.20 cm and 36.23 ± 13.74 kg respectively. Most of them had normal current weight (41.7%) and normal birth weight (86.7%). Overweight and obese represent 8.3% and 16.7% respectively, while underweighted children represent 33.3%. BMI was associated with child age, family opinion in child weight, birth weight and family history of obesity. Most of studied children took sufficient amount of animal protein, while consuming grains & carbohydrates, beans, vegetables, fruits and fats 4-6 times per week. 80.0% consume sweets & processed sugar 4-6 times per week. Consumption of junk foods and soft drinks and juices was high (66.7% for each) 4-6 times per week. Diet was statistically associated with BMI (frequency and standard requirements); overweight and obese children took carbohydrates & grains, soft drinks &juices and junk foods in amounts that above the standard requirements and in higher frequency compared to underweight and normal weight children (≥4 times per week). The consumption of vegetables and fruits was not related to BMI as most of participated children took them at the standard requirement.

Conclusion and recommendations

The prevalence of malnutrition disorder (underweight and obesity) among primary school children in 10th of Ramadan City is considerable. High BMI was associated with high frequency of eating carbohydrates& grains, soft drinks & juices, fats and junk foods and their daily requirements. Low BMI in underweight children not related to significant type of food as they mainly took their standard requirements in frequency around 4 times per week. Feasible and effective nutritional and educational programs for primary school children must consider child characteristics and eating habits.
Evaluation of Round Block Oncoplastic Breast Surgery in Early Juxta-Areolar Breast Cancer in Comparison to Standard Wide Local Excision (Retrospective Study)
Authors: Helmy Mohamed Ahmed , Rayyan Mahmoud Talaat , El-trras Hasan Reda
Published: August 2023

Background

Breast cancer is the most common cancer in women and the leading cause of women mortality all over the world. Oncoplastic techniques are replacing SWLE for better cosmetic outcomes and better exposure of the tumor.

Objective

To assess the round block technique as regard oncological safety, surgical outcomes and patients' satisfaction comparing results with standard wide local excision.

Patients and Methods

In our study 40 breast cancer patients are subdivided into group (A) 20 females which underwent round block technique and group (B) 20 femaleswhich underwent standard wide local excision. Patient and tumor criteria including age, family history, comorbidities, tumor side and histopathological results were considered to be non-significant between 2 groups so the only difference is the surgical technique.

Results

The study shows that round block technique has comparable post-operative parameters with less surgical complications and better cosmoses as it is scarless operation without nipple and areola shift suggesting that the round block technique is superior to SWLE in selected cases.

Conclusion

The round block technique has comparable post-operative parameters with less surgical complications and better cosmoses as it is scarless operation without nipple and areola shift suggesting that the round block technique is superior to SWLE in selected cases.
The Effect of Adding Pyloroplasty to Nissen Fundoplication in Improving the Outcome in Patients with Delayed Gastric Emptying Associating Gastro Esophageal Reflux Disease: A Meta-Analysis
Authors: Ezz Reda Saad Mohammad , El-Hefny Amr Mohamed Mahmoud , Hamed Mohammad Abdel Mageed Alsaid , Moneam Ayman Hossam Eldin Abdel , Sonbol Hoda Ali Ahmad
Published: August 2023

Background

An important consideration for patients with GERD is the possibility of underlying gastroparesis defined as delayed gastric emptying in the absence of mechanical obstruction. The addition of a pyloroplasty to nissen fundoplication in patients with GERD is said to improve bloating symptoms and promote faster gastric emptying.

Aim of the Work

The aim of this meta-analysis study is to identify the effect of adding pyloroplasty to Nissen Fundoplication in improving the outcome in patients with delayed gastric emptying associating Gastro esophageal reflux disease.

Patients and Methods

Types of studies used Published studies about the effect of adding pyloroplasty to Nissen Fundoplication in improving the outcome in patients with delayed gastric emptying associating Gastro esophageal reflux disease (carried out in the period between 2000 – 2020). The published English-language literature was searched in the databases PUBMED (US National Library of Medicine, Bethesda, Maryland) (2000 to present), EMBASE (Reed Elsevier PLC, Amsterdam, Netherlands) (2000 to present), as well as Google Scholar and Science direct.

The search terms was employed: “Pyloroplasty” and “Delayed gastric emptying” or “gastroparesis” and “Nissen’s fundoplication”.

Results

A total of four studies reported there was statistically significant decrease in the T1/2 postoperative (90.62 ± 15.64) than preoperative (192.42 ± 28.10) with p-value <0.001. The change from pre to postoperative t ½ with a total sample size of 164 patients. The overall effect estimates noted a significant reduction in the t ½ by 116.5 (95% CI 85.9 – 146.9) minutes. The pooled effect estimates showed significant heterogeneity (p = 0.016; I2 =71%). A total of four studies reported the rate of symptomatic improvement with a total sample size of 164 patients. The overall effect estimates noted a symptomatic improvement rate by 84% (95% CI 78.6 – 89.7%). The pooled effect estimates showed no significant heterogeneity (p = 0.66; I2 =0%).

Conclusion

Laparoscopic pyloroplasty with Nissen’s fundoplication is an effective procedure and might be considered as a first-line treatment for selected cases of gastroparesis. We report an 84% symptomatic improvement rate and 71% improvement rate for gastric emptying times measured by scintigraphy. The procedure can be performed with a minimally invasive technique with low morbidity and no mortality. The laparoscopic approach does not preclude subsequent procedures when required.
Role of Mesh in the Reinforcement of the Primary Repair of Large Hiatal Hernia
Authors: Gad Khalid Hussien , El Hefny Amr Mohamed M , Al Sayed Mohammed Abd Almegeed , Eldin Ayman Hossam , Elkaialy Hossam Abdelrahman Abdelrahman Yassin
Published: August 2023

Background

The incidence of hiatal hernias increases with age. Approximately 55%-60% of individuals over the age of 50 have a hiatal hernia. However, only about 9% have symptoms, and it depends on the type and competency of the lower esophageal sphincter.

Aim of the Work

In our study, an objective observational study was made regarding post operative short term mesh related complications possible to develop in patients underwent hiatal repair of large hiatal hernia with mesh rienforcement.

Patients and Methods

An observational cohort (retrospective and prospective) study regarding the post operative mesh related complications in patients who underwent Large diaphragmatic hernia repair with mesh application. The study was conducted at Ain Shams University Hospitals, Al-Demerdash, Department of General surgery. Approval of the research ethics Committee of medicine and general surgery department at faculty of medicine, Ain Shams University as well as a written informed consent from all participants was obtained. The study was conducted on 15 patients over a period of six months, starting from date of approval of the protocol by the faculty and the university committee at 10/7/2021.

Results

Five patients (33.3%) complained about dysphagia postoperatively. In one case, the symptoms declined spontaneously within 6 months was grade 1. Another patient successfully underwent esophageal dilatation of a stenosis 2 months postoperatively was grade 2. Up to this date, two patients (13.3%) still report mild dysphagia but maintain normal body weight were grade 3. Three cases report persistent intraabdominal discomfort without weight loss described as bloating. Two patients experienced heartburn, while another patient reported respiratory compromise in the form dyspnea due to already huge hiatal defect with lung collapse present preoperatively.

Conclusion

Laparoscopic large hiatal/paraesophageal hernia repair with prosthetic meshes as well as laparoscopic antireflux surgery with prosthetic hiatal closure are safe and effective procedures to prevent hiatal hernia recurrence and/or postoperative intrathoracic wrap migration, with low complication rates and mesh fixation is indicated in patients with large hiatal hernial defect > 5 cm.