bluuebunny/crossref_metadata_2025 huggingface dataset:
Endovascular Management of Intestinal Ischemia
Authors: Elassar Eslam Samy , Ali Ahmed Helmy , Monaem Rizk Mohammed Abdel , Majed Ibrahim
Published: July 2024

Background

Mesenteric ischemia requiring revascularization is associated with high mortality in both chronic and acute forms. Disparate etiologies and nonspecific symptoms make the diagnosis challenging and often result in delayed diagnosis and intervention. More often surgery is required and is frequently lifesaving. Percutaneous transcatheter techniques are increasingly employed in both diagnosis and treatment.

Aim and Objectives

To highlight the recent trends in management of patients with mesenteric vascular occlusion.

Subjects and Methods

This was is a prospective study, conducted at Ain Shams University Hospitals and Nasser institute Hospital in Cairo on 30 patients complaining of acute or chronic intestinal ischemia in the form of abdominal pain and post prandial meal.

Result

Among the studied cases there were 4 (13.3%) with complete effect of thrombolysis, 1 (3.3%) with partial effect, 2 (6.7%) with no lysis, 8 (25.7%) with dilatation, 13 (43.3%) dilatation and stent and 13 (43.3%) with failed dilatation.

Conclusion

Endovascular intervention can be an alternative to open surgery for intestinal revascularization for the management of early cases of acute SMA occlusion. CTA rapid diagnosis, urgent endovascular management and intensive care and follow up are the cornerstone for good prognosis.
Incidence of Thyroid Carcinoma in Multinodular Goiter versus Solitary Thyroid Nodule: Meta-Analysis
Authors: Kamal Ahmed Mohamed , Saad Ahmed Saeed , Abdellah Abdellatif Seham Alsayed
Published: July 2024

Background

Thyroid carcinoma (TC) is a relatively rare tumour, but it represents the most frequent form of cancer of the endocrine glands. It represents 1% of human neoplasias. Thyroid nodules are common. Palpable Thyroid nodules are found in 5% of persons aged an average of 60 years.

Objective

To determine the incidence of thyroid carcinoma in multinodular goiter versus solitary thyroid nodule.

Patients and Methods

Recent clinical trials or cluster trials, prospective and retrospective comparative cohort studies. Search results were uploaded to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart was introduced on the search results and the inclusion/exclusion criteria.

Results

Initially, 1240 observational studies were identified through the literature search. When the duplicates were removed, 1087 remained. Eight studies fulfilled the inclusion criteria and included in the meta- analysis. The study included five retrospective studies, two prospective and one Cross- sectional comparative study. The frequency of thyroid cancer among them varied from 13.7 9 to 41.4%.

Conclusion

To conclude, the current meta-analysis revealed that there is no difference between thyroid carcinoma in multinodular goiter and thyroid carcinoma in solitary thyroid nodule although malignancy in follicular thyroid carcinoma is higher in MNG than STN.
A Comparative Study in Elective Repair of Large Incisional Hernias Using On-Lay Mesh vs. Sub-Lay Mesh – A Meta-Analysis
Authors: Maaty Sameh Abdallah , Fawzi Fawzi Salah , El-Shayeb Bassem Helmy , Louiz Kamel Kirollos Adel
Published: July 2024

Background

Ventral abdominal wall incisional hernia is defined as a defect in the musculo-fascial layers of the abdominal wall in the region of postoperative scar. There is a slight increase in the incidence of incisional hernia in the female gender. The higher percentage of incisional hernia in females might be due to laxity of abdominal wall muscles after multiple pregnancies and also increased incidence of obesity in females.

Objective

To assess incisional hernia repair using two different techniques: on-lay mesh and sub- lay mesh, as regards operative time, postoperative recurrence, wound infection, seroma, hematoma and flap necrosis.

Patients and Methods

The Pubmed, web of science and Scopus were searched on 15 March, 2022. The keywords incisional hernia, sub-lay mesh on-lay mesh, retromuscular mesh, polypropylene.

Results and Conclusion

According to our results, there is a statistical difference between onlay and sublay regarding intra-operative time as sublay mesh is more time consuming. Regarding post- operative complications there is no statistical difference in recurrence, seroma, hematoma, flap necrosis and infection but there is a statistical difference regarding in hospital stay as patients with sublay repair stays less than onlay.
Laser Hemorrhoidoplasty vs Conventional Milligan-Morgan Hemorrhoidectomy for Treatment of Third and Fourth Degree Hemorrhoids: A Prospective Comparative Study
Authors: Mohamed Amer Hazem Abdelsalam , Kamal Ahmed Nabil , Abdel- Maksoud Ibrahim Magid , Fouad Elias Amir Adel
Published: July 2024

Background

Hemorrhoids are the most common disease of anal canal affecting a large number of people at least once during their lifetime and can interfere with their daily functioning. Surgical treatment is the best available option for symptomatic hemorrhoid cases, which are refractory to medical treatment. In spite of many modifications made to the hemorrhoid surgical techniques, postoperative pain and discomfort remain the major concern for patients, which is why they often refuse to undergo surgical treatment. Laser ablation has opened new possibilities for the minimally invasive treatment of hemorrhoids.

Objective

To compare the outcomes between laser hemorrhoidoplasty and the conventional Milligan-Morgan hemorrhoidectomy for treatment of third and fourth degree haemorrhoids especially postoperative pain, bleeding, and recurrence.

Patients and Methods

Recent studies have proven that laser ablation was much better regarding postoperative pain and hemorrhage in the various degrees of hemorrhoids. Our study also confirmed that laser ablation technique has shorter operative time, less severe postoperative pain, bleeding and comparable regression of hemorrhoid columns. Studies with longer follow-up period (around 2 years) have also reported effectiveness of laser for the treatment of hemorrhoids which was confirmed in our study over 6 months.

Results

Although some studies showed that wound inflammation or hemorrhoid thrombosis could be a problem however our study showed no postoperative local infection in the group treated with laser ablation and only two patients were presented with thrombosis of external hemorrhoid 7–10 days after the surgery, which was resolved with medical treatment.

Conclusion

Laser hemorroidoplasty has better outcomes than the traditional surgical resection of hemorrhoid disease for the control of grade III and IV symptomatic refractory hemorrhoids specially regarding post-operative pain and bleeding which are the main concerns for most patients.
Acute Kidney Injury in COVID-19 Patients
Authors: Wahab Saeed Saeed Abdul , Hassan Mohamed Saeed , Abu EL-Naga Moataz Mohamed
Published: July 2024

Background

This was a prospective study that was held in KOBRY ALKOBBA military complex to evaluate the prognosis of COVID-19 patients with Acute kidney injury (AKI). Evaluation of AKI in hospitalized patients with COVID-19, which included adult patients with laboratory and radiologically confirmed SARS-COV-2 infection admitted to ward and ICU patients at KOBRY ALKOBBA military complex, Cairo, Egypt.

Aim of the Work

The aim of this work is to study the incidence and outcome of Acute Kidney Injury (AKI) in all patients admitted with COVID-19 infection in ward and ICU during 3 months at Ainshams university hospitals.

Patients and Methods

A prospective cohort study for 3 months on Inward and ICU patients at Ainshams university hospitals. Informed consent was taken from each patient and study will be approved from ethical committee of the department of internal medicine faculty of medicine Ain Shams university.

Results

As a result, the findings of our study required additional validation. This study was conducted during the COVID-19 pandemic in a single medical center in Cairo governorate: thus, we were unable to generalize our findings to all individuals infected with COVID-19 in Egypt.

Conclusion

Incidence of AKI in our study was 9.19% in all patients admitted in ICU and ward during 3 months. Our findings suggest that COVID-19 cases, particularly those in ICU, should be closely monitored for the progression of AKI. Early detection of AKI and prompt meditation may improve COVID-19 patients outcomes. The occurrence of AKI is a poor prognostic factor in SARS-CoV-2 infected patients. The mortality rate in COVID-19 patients complicated with AKI group is very high.
Adherence of Mild and Asymptomatic Covid-19 Positive Patients to Ain Shams University Home Isolation Protocol
Authors: Farres Mohamed N , Wahba Hoda M F , El-Mahdi Amira R , Ali Alaa G H
Published: July 2024

Background

Egypt has reported almost 515,103 confirmed cases of coronavirus disease (COVID-19) with 24,779 deaths from January 3rd, 2020 to May 29th, 2022. To date, the clinical picture of coronavirus infection among Egyptian patients has not been well-characterized. Asymptomatic infection and mild cases make up a large proportion of infections all over the world. According to Ain Shams University guidelines, asymptomatic and mild cases can be isolated at home; however it is unclear to what extent patients adhere to home isolation guidelines, and whether home isolation was in fact effective in reducing infection among the patient’s family contacts.

Aim of the Work

The aim of this study was: Describe the socio-demographic characteristics of asymptomatic and mild patients eligible for home isolation and measure the adherence of patients isolated at home to the recommended control measures with telemedicine follow up.

Patients and Methods

This is a retrospective cohort study conducted in Ain Shams University on 400 patients who were diagnosed as positive for covid-19, classified as asymptomatic or mild cases at presentation and recommended for home isolation.

Results

In our cohort, Patients that were adherent to home isolation guidelines had similar household infection rate to those with less compliance except for those who had more than one bathroom, household infection had significant negative correlation to number of bathrooms (p = 0.003) because the patient was able to have personal bathrooms. Regarding family members, 57.8% of cases had members with no symptoms of COVID-19 and 43.2 % had members with symptoms or positive test.

Conclusion

Our study was limited with the low number of patients from a single centre. However, our findings showed that self-isolation at home may be an alternative to manage mild cases or asymptomatic patients when applied with careful and close observation.
Study of Relation between Advanced Oxidation Protein Product and Bone Mass Density in Type 2 Diabetic Patient
Authors: Sabry Inas Mohamed , Maher Mahdy Maram Mohamed , Zaytoun Hossam Abdelhafize , Elhalawany Salah Hussein , Ahmed Abou Elenin Moataz Abdel Monem
Published: July 2024

Background

Many disorders associated with diabetes, such as oxidative stress, hyperglycemia, and body weight, can be considered to be involved in the pathogenesis of diabetic bone disorder. Among them, oxidative stress may be a candidate, since it is increased under diabetic conditions and is known to induce cellular dysfunction in a wide variety of cell types. Reactive oxygen species (ROS) generated by high glucose concentrations are also considered to be a causal link between hyperglycemia and other metabolic abnormalities in the development of many diabetic complications.

Aim of the Work

This study evaluated the relation between advanced oxidation protein product and bone mass density in type2 diabetic patient.

Patients and Methods

This cross sectional study was conducted on 90 postmenopausal female patients aged from 50-60 years old, selected from endocrine outpatient clinic of Ain shams university hospitals for 12 months in a period from May 2019 to May 2020.

Results

AOPP was significantly higher in group I (diabetic patients) than group II. There were significant correlations between AOPP and (BMI, HbA1c, forearm, femur, spine T-SCORE) in group I and both groups but there were no significant correlations between AOPP and (menopause duration, age, creatinine, urea, eGFR, Ca level, phosphate level and PTH).

Conclusion

From the results of current study we can conclude that: AOPP is significantly higher in diabetic patient’s more than non-diabetic patients. Higher AOPP levels were associated with lower BMD. BMD of spine was significantly decreased in diabetic patients than other bony parts. AOPP was significantly increased with high BMI, HbA1c level
Frailty in Hemodialysis Patient
Authors: Abou Seif Khaled Hussein , Saied El Sharkawy Magdy Mohamed , Hassan Mohamed Saeed , Hosny Elsayed Atta Ahmed Amgad
Published: July 2024

Background

Frailty has been defined as a state of increased vulnerability to stressors as a consequence of degeneration in multiple systems. There remain two schools of thought with regard to frailty: one which sees frailty as a physical phenotype characterized by sarcopenia and another that views frailty as an accumulation of deficits across a variety of domains.

Aim of the Work

The aim of this study was to assess the prevalence of frailty among dialysis population.

Patients and Methods

This cross section study carried out in Hemodialysis Unit of the Nasr City Health Insurance Hospital between October 2020 and July 2021. The total number of the study was 325 hemodialysis patients, 25 were excluded from the study, thus the enrolled final number became 300 hemodialysis patients on maintenance hemodialysis therapy for at least 6 months.

Results

The mean age of the patients was 45.57±11.79 years (range 25-65 years) 50% of them were under 45 years of age. 258 (86%) of patients were males and 42 (14%) females, with male to female ratio about 6.14:1. 37 patients (12.3%) has positive HCV, while the results also show that none of the HBV and HIV of the study group. 10 patients (3.3%) of vulnerable, 89 (29.7%) patients at mild frailty, table also clarified that, 126 (42.0%) patients at moderat4e frailty, furthermore, 75 (25%) patients at severe frailty in Edmonton frail scale. There was significant positive association between frailty and age with p-value <0.001. Males more affected by frailty than females.

Conclusion

The differences in the frailty prevalence among CKD patients could be caused by the different definitions of frailty that each study adopted. It is important to prevent early-onset disability in end-stage renal disease, which may be accelerated by frailty in this patient population, which includes individuals who already carry a high risk of morbidity and mortality. We adopted the Edmonton Frail Scale (EFS) based on self-report, it is very simple to administer and can be carried out by hemodialysis nursing staff after minimal training, without the need for specialist medical staff, in less than 15 min. Its association with poor short-term outcome highlights its utility in detecting frail patients, but because it is a multi-domain test, it also gives health professionals information about which areas of frailty are affected. This would allow specialists to administer specific, more complex scales to detect deficits in independence for basic and instrumental activities of daily life, cognition, emotional status, and social support. Our findings allow us to recommend the inclusion of the frailty comprehensive assessment of patients starting the dialysis program to timely identification of frailty syndrome.
Evaluation of Eosinophil-Derived Neurotoxin Level and Asthma Severity in Isolated Asthma in Comparison to Asthma with Allergic Comorbidity
Authors: Osman El Mahdi Eman Naguib , El Sayed Hoda Mohamed , Mohamed Ali Manar Farouk , Mohamed Ibrahim Marwa Hussein , Irobe Abdiwahab Mohamed
Published: July 2024

Background

Asthma and associated type 2 inflammation are observed in 50–70% of patients with asthma and eosinophilic inflammation is a common feature in many asthma patients, and is associated with a higher risk of a more severe disease. Esinophilic Derived Neurotoxin (EDN) it’s useful as a clinical biomarker for the diagnosis and monitoring of asthma. High levels of EDN have been observed in patients with asthma, with higher levels measured during asthma exacerbations than in those with stable asthma.

Objective

To compare the association of the level of Esinophilic Derived Neurotoxin and burden of asthma in patients with asthma with Allergic comorbidities such as rhinitis and / or eczema compared to patients with asthma alone.

Methods

A cross sectional study included 100 adult patients, 50 patients diagnosed as asthma according to GINA guidelines and 50 patients diagnosed as asthma with allergic comorbidity such as Allergic rhinitis and/or eczema were selected from those who presented to the Allergy and clinical immunology clinics at Ain Shams University Hospitals during the period between January to July 2022.

Results

50% of the studied population had bronchial asthma alone while the remaining had asthma with allergic comorbidities with most of them had asthma with allergic rhinitis and Most of the patients with allergic rhinitis had mod/severe persistent AR. 77% of total patients had positive SPT and 23% had negative SPT. Most of the patients had positive result for dust mites (Dermatophagoides farina 35% and Dermatophagoides pteronyssinus 30%) followed by pollens (mugwort 27%, rye grass 26% and tobacco 13%) and Animal dander (horse hair 15%, sheep wool 14%, cat hair 13% and dog hair 12%). The Median (IQR) of absolute eosinophil count and total IgE were higher in patients with asthma with Allergic comorbidities [0.68 (0.58 – 0.83) cells/mm3 and 155 (120 – 350) IU/ml respectively] while patients with asthma alone were 0.25 (0.12 – 0.45) cells/mm3 and 68.5 (29 – 123) IU/ml respectively. Our study showed the Median (IQR) of Serum EDN level was higher in patients with asthma with Allergic comorbidities [34 (28 – 40) ng/ml] compared to the patients with asthma alone [15(11 – 18) ng/m]. The quality of life and asthma control test was poor in asthmatic patients with allergic comorbidities compared to patients with asthma alone.

Conclusion

Serum EDN, Absolute Eosinophilis and total IgE can be used as a marker of T2 inflammation of air ways as their levels were higher in asthma with Allergic comorbidities. Asthma with comorbidities has more symptom burden with poorer quality of life and lower asthma control test than asthma alone; with more concern to be taken for those patients with asthma comorbidities as they have more severe asthma and poorer quality of life
The Association of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio to the Prognosis of Acute Kidney Injury Patients
Authors: Okba Ashraf Mahmoud , Shaheen Rasha Youssef , Madbouli Norhan Nagdy , AboBakr Ferganey Eman Abdelsalam Mohamed
Published: July 2024

Background

Acute kidney injury (AKI) is an increasingly common problem facing clinicians, especially nephrologists, intensive care physicians, general physicians and surgeons. Acute kidney injury is a heterogeneous group of conditions characterized by a sudden decrease in glomerular filtration rate, manifested by an increase in serum creatinine concentration or oliguria, and classified by stage and cause.

Aim of the Work

The aim of the study was to evaluate the prognostic ability of the Neutrophil to Lymphocyte ratio, Platelet to Lymphocyte ratio and neutrophil to lymphocyte and platelet ratio in adult patients with acute kidney injury with various etiologies and to evaluate their role in the prediction of both morbidity and mortality over period of three months.

Patients and Methods

To achieve this goal, we conducted this study on 102 patients who developed acute kidney injury during hospital admission in Ain Shams University hospitals.

Results

he study found no significant differences between PLR and NLP ratios among different AKI stages. NLP ratio showed an inverse correlation with serum creatinine and a positive correlation with estimated Glomerular Filtration Rate (eGFR), while PLR did not show significant correlation. NLP ratio had the ability to predict the outcome of AKI with significant differences between mortality and recovery cases, while PLR did not have significant ability to predict outcome. NLP ratio showed high sensitivity and specificity in predicting the need for vasopressors, mechanical ventilation, or hemodialysis, while PLR had moderate sensitivity and high specificity in predicting recovery. The study had some limitations, including not enrolling non-AKI control group and not evaluating the effect of certain treatments on the studied markers.

Conclusion

The study had the advantages of being conducted on relatively large sample size and included patients of variable causes of admission. The included patients had also variable causes of AKI and of different AKI stages. The study had some limitations as we did not enroll non- AKI control group. We did not evaluate the effect of certain treatment modalities as some antibiotics or interventions on the studied markers.
Autoimmune Manifestations in a Cohort of Egyptian COVID-19 Patients
Authors: Mahmoud El Bakry Samah Abd El Rahman , Mohammad Hawwash Amr Mohammad , Abd El Rahman Sara Ahmed , ElSherbiny Dalia AbdelHamid
Published: July 2024

Introduction

COVID-19 infection can result in a range of symptoms, from asymptomatic to severe, requiring intensive care and ventilatory support. Research has explored the association between COVID-19 and autoimmune conditions, including the detection of autoantibodies in COVID-19 patients. However, results are not conclusive, prompting us to conduct a cross-sectional study to evaluate the prevalence of autoimmune rheumatic manifestations in a cohort of Egyptian individuals diagnosed with COVID-19.

Methods

Ninety individuals with COVID-19 were included in the study. Patients were classified based on WHO criteria and laboratory data was collected. Autoimmune markers (ANA, RF, ACL IgM, ACL IgG) were measured and patients were grouped based on positive and negative results. Correlational analysis was conducted to assess the association between each marker and clinical severity of COVID-19 and autoimmune rheumatological manifestations.

Results

Of the studied patients, 13.3% had a positive ANA, 15.6% had a positive RF, 8.9% had a positive ACL IgM, and 5.6% had a positive ACL IgG. However, there was no statistically significant difference between severity groups regarding the results of ANA, RF, ACL IgM, and IgG. All patients with a positive ANA were present among severe and critical COVID-19 cases, and all patients with positive RF, ACL IgM, or ACL IgG were among moderate, severe, and critical cases.

Conclusion

Our study provides insight into the prevalence of autoimmune rheumatic manifestations in COVID-19 patients. While our results were inconclusive regarding the association between autoimmune markers and severity of disease, we found a statistically significant higher prevalence of several symptoms in critical COVID-19 patients. Our study highlights the importance of further investigation into the relationship between COVID-19 and autoimmune conditions.
Fibro-Scan Based Score and Novel Noninvasive Serum Marker, FGF-21, to Assess Liver Fibrosis in Morbidly Obese Patients
Authors: Biomy Esem , Magdy Mohamed , El Disawe Mustfa Azab
Published: July 2024

Background

(NAFLD) is currently the most common cause of liver disease in the Western world, affecting up to 20- 30% of the general adult population. It is a growing public health problem, because of the increasing prevalence of the pathologies that contribute to its development such as obesity and inflammation status.

Aim of the Work

The study is aimed to develop and validate noninvasive scoring system for assessment liver fibrosis in morbidly obese patients with NAFLD.

Subjects and Methods

This is a Prospective cohort study, was carried out on 50 morbidly obese patients selected from internal medicine department, El Demerdash Hospital, through a period of six months.

Results

There were 32(64.0%) male and 18(35.0%) female with mean age 40.48 (± 12.16) SD. There were 14(27.0%) between (20 -30), 11(22.0%) between (30-40), 9(18.0%) between (40-50) and 16(32.0%) ≥50. Mean Weight (Kg) was 106.6 (± 13.31) SD with range (82.50 – 145.5), mean Height (Cm) was 171.7 (± 6.25) SD with range (158.0 – 185.0), mean BMI (Kg/m2) was 36.17 (± 4.15) SD with range (29.30–43.40), mean Waistcircumference 113.1 (±7.64) SD with range (92.0 – 129.0). There were 37(74.0%) with Co-morbidity. 10(20.0%) have DM, 11(22.0%) have HTN, 11(22.0%) have CDK and 5(10.0%) have COPD.

Conclusion

That the combination of Fibroscan and, APRI, FGF-21 and FIB-4 methods provides a valuable approach for assessing liver fibrosis in NAFLD patients. This can eliminate the need for liver biopsy in patients without clear indication. In addition, several recent studies have also validated the used of non-invasive markers in the diagnosis of NAFLD. The establishment of a national program for the recognition of NAFLD is therefore essential to reduce the risk of liver disease progression.
Prophylactic Intravitreal Methotrexate Infusion during Vitrectomy to Prevent Proliferative Vitreoretinopathy in Cases of Rhegmatogenous Retinal Detachment
Authors: Fouad Aziz Joseph Hany , El-Shazly Mohamed Abd Al Hakim Zaki Amany A , El-Zarakany Tarek Ahmed El-Ma’moun
Published: July 2024

Aim

To assess the efficacy and safety of intravitreal methotrexate (MTX) infusion (IMI) during pars plana vitrectomy (PPV) in patients with rhegmatogenous retinal detachment (RRD) to prevent proliferative vitreoretinopathy (PVR) in patients with established PVR grade C and patients at high risk for PVR development.

Settings and Design

A prospective comparative interventional study conducted from September 2020 till November 2021 at Ain Shams University Hospitals, Egypt.

Materials and Methods

Forty-seven eyes of patients with RRD undergoing PPV were divided into case group receiving IMI during the surgery and control group. Each group was subdivided into a subgroup with high-risk patients to develop PVR and a subgroup with established PVR grade C preoperatively. Outcome measures at the end of three months postoperatively were retinal attachment rate, incidence of PVR, reoperation rate to flatten the retina and the changes in retina and/or optic nerve function assessed by full field electroretinogram (ff-ERG) and flash visually evoked potential (VEP)

Results

Seven cases (15%) and four cases (9%) developed PVR after one month and three months respectively. Five cases (10 %) required reoperation to re-flatten the retina, 43 cases (91 %) had complete flattening of the retina after three months. No statistically significant differences were reported between the studied groups regarding the studied outcome measures, and no serious adverse events were reported secondary to IMI.

Conclusion

IMI use was found to be safe in intraocular use, but it did not affect the anatomical success rate.

Key words: Proliferative Vitreoretinopathy, Recurrent Retinal Detachment, Electrophysiology.

Key Messages: More studies need to be conducted to further evaluate if MTX has a role in the prevention of PVR after vitrectomy.
Preoperative, Intraoperative and Post-Operative Optical Coherence Tomography for Pediatric Epiretinal Membranes Presenting with Strabismus
Authors: Alfeky Mariam
Published: July 2024

Purpose

To highlight the value of optical coherence tomography (OCT) in the surgical decision making process of pediatric epiretinal membranes (ERMs).

Methods

A retrospective interventional case series that included the review of records of pediatric cases with ERMs presenting with strabismus who underwent pars plana vitrectomy by a single surgeon from March 2018 till June 2022. Demographic, clinical, and surgical details were extracted, as well as follow-up visits and outcomes.

Results

Five eyes of 5 cases with unilateral squint secondary to ERM were included. Age at presentation ranged from 2-7 years (mean 3.6 +/- 1.9), The male to female ration was 4:1. Two cases (40%) were idiopathic, 2 (40%) were secondary to familial exudative vitreoretinopathy (FEVR) and 1 (20%) was secondary to traumatic rupture globe. Preoperative and postoperative OCT was obtained in all cases, while preoperative fundus fluorescein angiography was obtained in 4 cases (80%). Intraoperative OCT was used in 4 cases (80%) to confirm complete release of the membrane from the fovea, and ILM was peeled in 3 cases (60%). The decision for surgical intervention and plan of surgery was totally dependent on preoperative OCT to confirm the extent of the ERM and the plane of cleavage. Intraoperative OCT helped assess areas of strong adherence of the membrane to avoid iatrogenic retinal injury. Initial restoration of the foveal anatomy with appearance of the fovea was seen after 3.6 +/- 2.8 months from the surgery with a range of 1-8 months. Squint improvement was seen in all cases. Time range to squint improvement was 1-4 months (mean 2.8 +/- 1.6). One case (20%) continued 4 years of follow up and two cases (40%) terminated follow up at 6 months due to squint improvement. Only one case (20%) showed progressive myopia post-surgery and one case did not achieve complete restoration of the fovea.

Conclusion

Surgical removal of pediatric epiretinal membranes presenting with strabismus leads to squint and visual improvement even if complete restoration of the foveal anatomy has not been reached yet. Combined use of preoperative, intraoperative and postoperative OCT in those cases helps better surgical and anatomical outcomes.
Role of Optical Coherence Tomography (OCT), Fundus Photography, and Amsler Grid in Detection of Macular Disorders Associated with High Myopia
Authors: El-Ibiary Hany , Ahmed Ebeid Weam Mohamed , El-shinawy Reham Fawzy , Al Maharekey Kareem Atef
Published: July 2024

Background

High myopia refers to ametropia characterized by elongation of optic axis and retinal and choroidal degeneration in the fundus, and high myopic patients present with various degrees of structural and functional retinal changes and thinning of the retinal thickness. Active screening for high myopic patients with imaging techniques by OCT, Fundus photography and amsler grid and providing patients with corresponding treatment on this basis may effectively reduce the risk of irreversible visual function damage.

Objective

To point to the importance of combining OCT, fundus photography with amsler grid testing in patients with high myopia.

Methods

This study was conducted on 40 eyes from EI-Demerdash Hospital outpatient clinic and ophthalmology department investigations unit in the period from June 2021 till May 2022; the patients were 24 females (60.0%) and 16 males (40.0%) with age ranged from 16 to 50 years.

Results

Our investigations gave us an idea about the macular diseases associated with high myopia and the importance of combining use of OCT, fundus imaging and amsler grid with patients with high myopia. These findings consist of chorioretinal atrophy, foveoschisis, choroidal neovascularization, dehiscence of retinal layers known as retinoschisis (foveoschisis or extre foveoschisis), macular holes (lamellar and full thickness), posterior retinal detachment. We can early detect theses changes in macula of highly myopic patients by Amsler grid testing as daily self monitoring and this can be useful in directing the patient to more sophisticated investigation tool like OCT and fundus photography and therefore give the patient the optimal chance to save the vision.

Conclusion

OCT combined with fundus photography and amsler grid testing are helpful tools that allow detailed evaluation of the macula in eyes with pathological myopia and easily anticipate, diagnose and follow up diseases associated with high myopia.
A Systematic Review for Difference between Free and Pedicle Recycling Bone Autograft in Limb Reconstruction in Bone Tumors
Authors: Rahman Moustafa Mohamed AbdEL , Azmy Sherif Ishak , AbdElraof Ali Mohammed Ezeldin
Published: July 2024

Background

The use of liquid nitrogen for management of the primary lesion in osteosarcoma, was first described in 1984. Surgical use of liquid nitrogen was first reported by Cooper 91 in 1962. Since then, many tumors have been treated locally with liquid nitrogen.

Aim of the Work

The aim of this study is to review systematically studies to show if there is a difference between pedicle and free freezing in liquid nitrogen in reconstruction after long bone tumors in union and complication.

Patients and Methods

Between 1999 and 2020 about 235 patient had limb salvage procedure by recycling of bone bearing tumor in liquid nitrogen out of them 205 patient included in this study were inclusion criteria are: Humans: male and female, age from 4 to 80 years, patients with malignant bone tumors either primary or secondary, different methods of fixation are included and minimal follow up of 12 months.

Results

There are two techniques to recycle bone bearing tumor in liquid nitrogen ether FFP through en block resection of bone bearing tumor and to be recycled separately in liquid nitrogen then fixed in proximal and distal endes OR PFP through performing one side osteotomy maintaining the continuity of the bone with the body and emerge the bone bearing segment in liquid nitrogen and then fix the segment in it’s posttion after completing the recycling.

Conclusion

We searched to clarify differences between these two methods systematically regarding union time, functional scores, outcoms and complications as infection, graft failure, recurrence & skin necrosis.
Effect of Previous Hip Arthroscopy on Results after Hip Arthroplasty: Systematic Review and Meta-Analysis
Authors: Asal Mohamed Kamal , Mounir Ayman Fathy , Moris Georgeos Gerges Salah
Published: July 2024

Background

Hip arthroplasty is the most frequently performed adult reconstructive hip procedure. Total hip arthroplasty (THA) is one of the most successful procedures performed in modern orthopedics. The primary indication for THA in a patient with endstage arthropathy is pain resulting in significant limitation of physical activity. Important factors to be considered in the decision to recommend or undergo THA are patient age, diagnosis, and medical comorbidities.

Aim of the Work

This review pursues to systematically review the current evidence in the literature to determine whether previous hip arthroscopy would direct to inferior results in patients undergoing succeeding hip arthroplasty.

Patients and Methods

The first literature search identified 412 studies in total. After removing duplicates, 307 articles were deemed irrelevant based on their title and Abstractscreening. Eighty- two papers were eliminated from the remaining 105 research based on their title and Abstract. After carefully reviewing the entire text of all remaining publications, 11 studies were eliminated for reasons such as conference Abstracts, reviews, and lack of comparison between intervention and control groups. Additionally, one cohort research that compared THA results in patients who had previously undergone hip salvage surgery to those who had not previously undergone hip salvage surgery was removed. Finally, eleven studies spanning the years 2012 to 2019 were available for meta-analysis.

Results

Of these citations could result from the studies’ varying designs and sample sizes. Estimated blood loss, on the other hand, was deemed a reasonable indicator of operating time. The consistency in blood loss between the groups may reflect a similar operative time.

Conclusion

Patients who have previously undergone hip arthroscopy are more likely to experience postoperative complications such as dislocation, revision, and reoperation following subsequent hip arthroplasty. On the other hand, prior hip arthroscopy did not appear to affect functional or intraoperative results.
Application of Autologous Bone Graft versus Non Grafting in Medial Opening Wedge High Tibial Osteotomy Less than 14 mm: A Systematic Review and Meta-Analysis
Authors: Moneim Eid Mohamed Abdel , Zakaria Zeiad M , Fahim Mohamed ELSokkary Ahmed Mamdouh
Published: July 2024

Background

Unicompartmental Knee osteoarthritis KOA due to varus malalignment is increased in young active patients which occurs predominantly in the medial compartment.

Aim of the Work

The objective of this study to compare MOWHTOs with autologous bone graft and without bone graft (wedge space mean less than 14 mm) in treatment of unicompartmental KOA and varus malalignment of the knee to determine which is better in decision-making according to outcomes.

Patients and Methods

Studies that matched the inclusion criteria were included in this meta-analysis. participants with medial compartmental knee osteoarthritis and varus malalignment were shown in the investigation. The age of the participants was unrestricted. Plate as a fixation method was the only option regardless of plate type. During 2000 and 2021, a research study of internet databases (Egyptian Universities Research, Medline, PubMed, Cochran library, medical journals) was conducted. Following that, the references from the user research were examined, and specialists were approached for assistance in locating other papers. Two independent reviewers extracted data separately and cross-checked it.

Results

The Knee Society Knee score (KSKS) and Knee Society Function score (KSFS) are most commonly used for the assessment of the knee joint reveled that there is no statically significant difference between bone graft vs non graft. Regarding this systematic review the radiological outcomes, the clinical bone union and the full weight bearing movement, are rendering any statistical analysis meaningless. Regarding complications presented, there was a similar tendency for complication rate when compared according to grafting or non- grafting. The use of autograft accelerates radiographic healing of the osteotomy gap after OWHTO while shorten the union time but confers no advantages in terms of functional or patient elated out comes at 3 or 12 months postoperatively.

Conclusion

MOWHTO can be performed without a graft with less operative time and avoiding graft harvest comorbidity with similar clinical and radiological results regarding bone union and posterior tibial slope alteration and knee scores.
Fixation Vs Arthroplasty for Management of Geriatric Distal Femur Fractures
Authors: Khalil Gendya Amr Gamaleldin Mahmoud , El-Zaher El-Zaher Hassan , Zakaria Zeiad Mohamed , Abdelhamid Metwaly Radwan Gamal Eldeen , El Sayed Awad Mohamed
Published: July 2024

Background

Distal femur fractures are considered challenging to manage, particularly in geriatric patients. Double plating (DP) is a technique that helps with earlier rehabilitation and return to pre-injury level of activity. Distal femoral replacement (DFR) is an alternative technique in the management of these fractures that may help to solve problems like associated knee osteoarthritis, osteoporosis, and severely comminuted condyles. The current study compares the functional and radiological outcomes of DFR and DP in the management of these fracture among geriatric patients.

Methods

This randomized, comparative, interventional study was performed at a university hospital. A total of 30 patients who underwent DFR or DP after distal femur fractures (AO/OTA 33 A3, 33 C) were analyzed. The primary outcome was Knee Society Score (KSS), whereas secondary outcomes included postoperative complications rate, knee range of motion (ROM), reoperation rate, and operative time.

Results

No significant difference was observed between DFR and DP except for the knee component of the KSS at 12-month interval (p = 0.03), and knee ROM at 12-month interval (p = 0.001), both of which were in favor of DP. No significant difference in postoperative complications (p = 0.06), reoperation rate (p = 1.00), or operative time (p = 0.06) were noted.

Conclusion

DFR and DP had comparable functional (KSS) and radiological outcomes with no significant difference in postoperative complications, reoperation rate, or operative time.
Management of Proximal Femoral Metastasis “Systematic Review/Meta-Analysis”
Authors: Fahmy Ibrahim Fady Micheal , El Mowafi Mohamed Ahmed , Ahmed Assem Bastawisy , Alian Zidan Alaa Ragab
Published: July 2024

Background

Adequate treatment of patients with proximal femur metastases demands higher level of attention due to the increasing life expectancy, and the need of maintaining good functional integrity and quality of life. In the presence of impending or actual pathologic fracture, treatment requires a reconstruction which provides pain control, stable and secure fixation and allows for immediate weight-bearing.

Objective

to evaluate management of proximal femoral metastasis as regards: functional outcome, oncological outcome and complications.

Material and Methods

This systematic review was conducted on human subjects in different literatures collected from different medical websites before 2022 in which we compared osteosynthesis including IMN (group 1) and reconstruction whether endoprosthesis replacement, total hip arthroplasty or hip hemiarthroplasty (group 2) in treatment of proximal femoral metastasis.

Results

Osteosynthesis results in a high recurrence, failure rate and non-union, while Dislocation rates and infections were common in reconstruction. the survival rate was prolonged in reconstruction than in osteosynthesis by IMN.
The Lateral Sinus Tarsi Approach in Fixation of Displaced Intra-Articular Calcaneal Fracture. A Systematic Review & Meta Analysis
Authors: El-beltagy Atef Mohmad , Abdel-Wahab Mahmoud Mohammed , Mosaad Abanoub Nabil
Published: July 2024

Background

Minimally invasive reduction and fixation techniques via a sinus tarsi approach (STA) have been developed in an attempt to avoid the potential complications associated with an extensile lateral approach (ELA) and to be less invasive.

Objective

Minimally invasive approach including sinus tarsi approach (STA) in displaced intra articular calcaneal fracture displaced intra-articular calcaneal fractures (DIACF) with reference to: Change from baseline in calcaneal height, change from baseline in calcaneal width, change from baseline in calcaneal length, change from baseline in Bohler angle, change from baseline in Gissane angle.

Methodology

This meta-analysis was carried out in accordance with the Cochrane Handbook of Systematic Reviews of Intervention and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to answer the question of minimal invasive of lateral sinus tarsi in displaced intra articular calcaneal fracture. The study protocol was registered into the International Prospective Register of Systematic Reviews on September 09, 2020 with a registration number (PROSPERO: CRD42022359197).

Results

Running our search strategy on PubMed 69 studies, and the Cochrane library resulting in 221 studies and trials. We discarded 12 studies after screening the title and Abstract. Then we screened 18 studies to assess their eligibility for inclusion; and in last 10 years. The total sample size for this meta-analysis was 12 participants. 484 patients who completed STA surgery and 514 patients completed ELA surgery.

Data Sources

Medline databases (PubMed, cochrane) and all materials available in the Internet till 2023.

Conclusion

In conclusion, using the minimally invasive sinus tarsi approach (STA) is associated with a significant change in calcaneal height and Gissane angle when compared to extended lateral approach (ELA) when used to manage the displaced intra-articular calcaneal fractures (DIACF).
Compliance and Ketones Levels in Relation to Seizure Control in Children with Drug Resistant Epilepsy Treated with Ketogenic Diet
Authors: Shatla Hamed M , Elgendy Yasmin G , Shata Mennatallah O , Ibrahim Haya E , Mohammed Tasneem M
Published: July 2024

Background

The ketogenic diet (KD) is a high-fat, adequate-protein, low-carbohydrate diet. Ketogenic diet therapy (KDT) has become an important option in the management of drug- resistant epilepsy and some of the inborn errors of metabolism in children, with increasing evidence of its favorable effects.

Objective

To evaluate patient's compliance to KD in children with drug resistant epilepsy (DRE) and the effect of KD on course and outcome of DRE.

Methodology

This cross-sectional study included 42 children whose age ranged between 1 month and 18 years with drug resistant epilepsy (DRE) on ketogenic diet for at least 3 months. They were recruited from the Ketogenic Diet Clinic, Children’s hospital, Ain Shams University, Cairo, Egypt. They were assessed for anthropometric measurements, betahydroxybutyrate (BHB) in blood,and acetone in urine, fasting lipid profile,serum random blood sugar;The frequency and severity of convulsions were assessed using chalfont severity scale before and after applying KD and correlated with the laboratory markers measured.

Results

Beta hydroxybutarate levels in blood ranged from (0.1 - 4.6) achieving ketosis in 37patient (BHB>2 mmol/L). As regard frequency of convulsions per day there was highly significant decrease after 3 month of KD with p < 0.001 compared to that before using the KD. On applying chalfont seizure severity scale on our patients there was highly significant decrease in the severity of the seizure with p < 0.001 after KD. Regarding the frequency of possible complications associated with KD, 69% of the patients had no complication, while 26.2% had constipation, 26.2% had hyperlipidemia, 2.4 % had vomiting, 2.4 % had kidney stones, and 2.4 % had urinary gravels.

Conclusion

KD is an effective, safe, and tolerable therapy for children with DRE where significant improvement in both frequency and severity of seizures after KD were found.
Value of Transabdominal Sonographic Rectal Diameter in Children with Functional Constipation
Authors: Boules Ireny Sefain , Hamdy Ahmed Mohamed , El Sayed Sakr Hossam Moussa , Awad Yosra Mohsen
Published: July 2024

Background

Constipation is a common problem worldwide. Since rectal digital examination and abdominal radiography have both limitations, ultrasound is considered an alternative technique, thus the aim of the current study is measurement of rectal diameter among a group of children with functional constipation (FC) in comparison with a healthy control group to determine the diagnostic efficacy of dilated rectal diameter for diagnosis of constipation.

Patients and Methods

A case control study that was conducted on children aged between 2 and 10 years; 50 were cases with functional constipation who were recruited from gastroenterology department and an equal number of age and sex matched apparently normal and healthy children were included as a control. FC was diagnosed according to the ROME IV criteria. Pelviabdominal ultrasound was done to all cases and controls to assess the rectal transverse diameter after taking detailed history regarding personal history, symptoms and history of present illness, past history and family history.

Results

Rectal diameter was measured in cases initially on presentation where 80% of the cases had enlarged rectal diameter, and 20% of cases had normal rectal diameter, ranging from 1.6 cm to 4.7 cm with a median of 3.55, while only 8% of controls has enlarged rectal transverse diameter and others were normal (P value <0.001).

Conclusion

based on our results, it can be concluded that rectal diameter is. significantly enlarged in most cases with constipation.