bluuebunny/crossref_metadata_2025 huggingface dataset:
Unilateral versus bilateral Pedicle Screw Fixation associated with interbody fusion in degenerative Lumbar spine diseases
Authors: Emara E E A , Morad S H , Farghaly A R , Ahmed O E , Khalil M K
Published: May 2020

Background

Lumbar interbody fusion is a recognized surgical technique in treatment of degenerative lumbar instability. Interbody fusion supplemented with pedicle screw fixation has several advantages over posterolateral fusion and has been advocated to improve fusion rates and clinical outcomes. Interbody fusion places the bone graft in the loadbearing position of the anterior and middle spinal columns thereby enhancing the potential for fusion. In addition, the interbody space has more vascularity than the posterolateral space, also increasing the potential for a solid fusion mass to form.

Aim of the Work

to assess safety and efficacy of unilateral pedicle screw fixation associated with interbody fusion in Lumbar spine degenerative diseases and to evaluate and compare outcomes of unilateral versus bilateral pedicle screw fixation associated with interbody fusion in lumbar spine degenerative diseases, as regard the operation time, bleeding, postoperative stay, cost, and the clinical and biomechanical results.

Material & Methods

This observational prospective comparative study of the 2 groups who were operated either unilateral (Group A /25 patients) or bilateral (Group B/25 patients) pedicle screw fixation with interbody fusion was done. Patients were followed up for 1, 6, 12 months. This study occurred at Ain Shams University hospitals.

Results

No differences were observed between the two groups with respect to demographic data. The patients of the two groups had significant improvement in functional outcome compared to preoperatively, except in early postoperative VAS back and ODI in unilateral group which is better than bilateral group. However, no significant difference noticed in the further follow up. There was no significant difference comparing fusion rate, complication rate and duration of hospital stay between the two groups at postoperative follow-up. There was significantly less blood loss, shorter postoperative pain killer use and significantly shorter operation time in the unilateral PS fixation group as compared with the bilateral PS fixation group in our study.

Conclusion

Our study suggested TLIF with unilateral PS fixation was as safe and effective as that with bilateral PS fixation. Unilateral PS fixation may significantly reduce the intraoperative blood loss and shorten the operation time, somewhat improve the clinical outcome scores of ODI and VAS Back without significant difference comparing fusion rate, complication rate and duration of hospital stay between the two groups at postoperative follow-up. BPSF with TLIF likely causes more degeneration at the cranial adjacent segment compared with UPSF techniques. However, the long-term follow up is required to demonstrate the impact of these findings.
The Reliability and Validity of the Thoraco-Lumbar Injury Classification and Severity score
Authors: Sabry I H , Toubar A F , Ahmed O A , Alashwal M I
Published: May 2020

Background

The TLICS/TLISS is a recently introduced classification system for thoracolumbar spinal column injures designed to simplify injury classification and facilitate treatment decision making. Before being widely adopted, the reliability and validity of the TLICS/TLISS must be studied.

Aim of the Work

To determine the interrater and intrarater reliability and the validity of the TLICS score and its predecessor the TLISS scoring system in the clinical practice.

Patients and Methods

A total of 7 articles with 10 datasets were used to test the inter- and intrarater reliability and validity of the TLICS/TLISS score for thoracolumbar spine trauma. Included studies presented Thoracolumbar trauma cases’ details (including clinical data, plain radiographs, CT scans and MRI) to spine surgeons allowing them to score them using the TLICS/TLISS score in each of its components (neurologic status, PLC integrity and fracture morphology/mechanism), the final score and surgeons’ agreement with the scores treatment recommendations; as well as comparing the treatment recommendations (surgical vs non-surgical management) with the treatment the patients actually received. At a later time the surgeons were assigned the task with the cases reordered. The interrater reliability, as well as the intrarater reliability of the score for each component and sum, were evaluated by Cohen’s unweighted k-value and Spearman’s rank order correlation. In addition, the sensitivity and specificity of the score (validity) were evaluated by the percent of correct treatment recommendations according to the sum of the TLICS/TLISS and the treatment actually received by the patients.

Results

Interrater reliability assessed by generalized kappa coefficients was 0.45 ±0.17 for injury morphology/mechanism, 0.91 ±0.03 for neurologic status, 0.42 ±0.13 for posterior ligamentous complex status, 0.36 ±0.14 for TLICS/TLISS total, and 0.59 ±0.10 for treatment recommendation. Respective results using the Spearman correlation were 0.52 ±0.18, 0.95 ±0.05, 0.57 ±0.13, 0.75 ±0.10, and 0.64 ±0.20. Intrarater kappa coefficients were 0.53 ±0.14 for injury morphology/mechanism, 0.89 ±0.07 for neurologic status, 0.53 ±0.15 for posterior ligamentous complex status, 0.46 ±0.16 for TLICS/TLISS total, and 0.61 ±0.02 for treatment recommendation. Respective results using the Spearman correlation were 0.63 ±0.08, 0.90 ±0.03, 0.64 ±0.10, 0.77 ±0.03, and 0.60 ±0.02. The percent of correct treatment recommendation by the score and the treatment actually received by the patients was 94.4% ±1.5, with sensitivity of 0.91 ±0.06, specificity of 0.94 ±0.01, PPV of 0.94 ±0.01, NPV of 0.93 ±0.02.

Conclusions

The TLICS/TLISS score has good reliability and validity and it compares favorably to other contemporary and old thoracolumbar fracture classification systems.
Predictive Accuracy of Three Dimensional Ultrasound Measurement of Fetal Adrenal Gland Volume in Preterm Labor Cases
Authors: Eltantawy W H A , Mohyieldin M M N , Mohammed A H
Published: May 2020

Background

Preterm birth is one of the major clinical problems in obstetrics and neonatology as it is associated with perinatal mortality, serious neonatal morbidity and in some cases childhood disability. It is reported that more than 80% of all neonatal mortality and morbidity is due to preterm birth.

Objective

In this study fetal adrenal gland volume and fetal zone measurement were used as a predictors for occurrence of labor in singleton pregnancies complicated by threatened preterm labor in comparison to cervical length and cervicovaginal fetal fibronectin.

Methodology

The study was carried out at Ain Shams University Maternity Hospital. The current study include 88 pregnant women who presented with symptoms or signs of threatened preterm labor (PTL). All women were subjected to full history taking, full general, abdominal, pelvic examination, in addition to ultrasound fetal biometry, measurement of cervical length, measurement of fetal fibronectin, fetal adrenal gland volume AGV and fetal zone acquisitions.

Results

Our results showed high statistically significant difference between the two groups of women regarding CL measurement, FZE and cAGV with P values < 0.001 suggesting that ultrasound examination of fetal adrenal gland and assessment of FZE at time of evaluation for symptoms of PTL may be clinically beneficial in predicting the occurrence of labor in pregnant women at risk of preterm labor.

Conclusion

Our results demonstrate that in women presenting with threatened preterm labor, cAGV and FZE measured by 3-dimensional ultrasound seem to be significant predictors of delivery within 7 days, when compared to CL and cervicovaginal fetal fibronectin.
Insertion of Intrauterine Contraceptive Device at Cesarean Section: Randomized Clinical Trial
Authors: Elkholy A G A , Sweed M S , Bartella H N
Published: May 2020

Background

Postpartum period is highly vulnerable period to unintended pregnancy as there are limited contraceptive options available in the breast feeding women. At the same time ovulation is highly unpredictable in non breast feeding or non exclusive breast feeding women. an ideal time to begin contraception, as women are highly motivated to adopt contraception at this time, which also has the advantages of being convenient for both women and health care providers.

Objective

To evaluate and compare the efficacy of IUD (Pregna T Cu 380A) insertion at cesarean section and after puerperium in terms of expulsion rate, pain and amount of bleeding.

Patients and Methods

This study is a randomized Clinical Trial that was conducted at Ain Shams University Maternity Hospital during the period from December 2017 to May 2018. The study was approved by institute ethics committee of Ain Shams University Hospitals.

Results

There were no statistical significant differences in the rates of wound infection, postoperative pain, volume of bleeding, signs of infection, additional analgesic needs, dyspareunia and number of days till bleeding stops between both groups. There was no statistical significant between both groups as regard expulsion of IUD in the present study.

Conclusion

IUD is a contraceptive device which is commonly inserted after puerperium. This study will focus on insertion IUD during cesarean section.
Hospital Versus Home Management in Women with Pre-Labor Rupture of Membranes: RCT
Authors: Ammar E E M A , Hussein A M , Khaled R A
Published: May 2020

Background

Pre-labor rupture of membranes (premature rupture of membranes (PROM) is defined as rupture of fetal membranes before onset of labor in women after 37 weeks of gestation. And it accounts for 10% of all gestations. Latent period is the interval between PROM and time of onset of labor. More accurate prediction of latency period could help prepare patients for anticipated length of hospital stays.

Objective

To find out if there is difference between home management and hospital expectant management in women with PROM as regard maternal and fetal outcomes.

Patients and Methods

Our study is a prospective randomized controlled trial to compare hospital versus home management in women with PROM, whom came to Ain Shams Maternity Hospital, as regard latency period, successful vaginal delivery, chorioamnionitis, NICU admission, and time from rupture of membrane till delivery, who attending the emergency room during the period from June 2017 till June 2018. A total of 152 pregnant women were included in this study who met inclusion and exclusion criteria, they divided into 2 groups, each 76 woman. Group A discharged home after initial assessment, Group B admitted to hospital.

Results

The present study found that there was a highly statistically significant difference (p < 0.001) between home group and hospital group as regard length of hospital stay. While there was no significant correlation (p > 0.05) between the two groups as regard mode of delivery or adverse maternal or neonatal outcomes.

Conclusion

As regard home management for women with PROM in comparison with hospital management, they had longer latent period as well as longer time interval between PROM and delivery, but had a shorter hospitalization stay without negative impact on maternal or fetal outcome. In times of increasing financial pressure on the medical system, outpatient management for PROM seems to be a viable option. Also multiparous women were more satisfied with their care, and reported that they ‘would participate in the study again’ if they were cared for at home rather than in hospital.
Titrated oral misoprostol solution versus vaginal misoprostol for labor induction in primi gravid ladies
Authors: Abdalfattah I M , Mohammed W E , El-gaml A A
Published: May 2020

Background

It is now generally accepted that the uterine cervix plays an important role during pregnancy and labor and that it depends on an active ripening process within the cervix; which is necessary for successful labor induction.

Aim of the Work

to test the safety and efficacy of titrated oral misoprostol compared to vaginal misoprostol for labor induction in term gravid ladies.

Patients and Methods

This prospective, single-blinded randomized controlled clinical trial was conducted at Ain-Shams University Maternity Hospital during the period between August 2017 and August 2018. 120 pregnant women planned for induction of labor were recruited in the study according to the inclusion / exclusion criteria. Subjects included in the study were randomized into two groups: patients who received oral 200 ug misoprostol in 200 ml water titrated over 24 hours and placebo tablets vaginally which resemble vagiprost tablets (25 microgram misoprostol) and the second group contained pients who received vaginal misoprostol 25microg maximum four doses, and placebo solution of 200 ml of tap water.

Results

titrated oral misoprostol is as effective in promoting cervical ripening and inducing labor as intravaginal misoprostol, oral Misoprostol has a similar maternal and perinatal safety profile to vaginal misoprostol.

Conclusion

This new approach to oral misoprostol administration was successful in minimizing the risk of uterine hyper-stimulation, which has been a feature of misoprostol use for induction of labor, at the expense of a somewhat slower response. Oral Misoprostol has a similar maternal and perinatal safety profile compared to vaginal misoprostol.
Intravaginal isosorbide mononitrate in addition to misoprostol versus misoprostol only for induction of labor: a randomized controlled trial
Authors: Harb H M , Mansour D Y , Abouahmed Y M A M E
Published: May 2020

Background

Induction of labor is still a controversial obstetric procedure. The need to shorten delivery time has been recognized and practiced for centuries. Although the indications have clearly changed during the past decades from a need to expel a dead fetus to an effective solution to reduce the threat to the mother and her precious fetus, effective and safe methods of achieving delivery must always have been the primary objectives. Induction is indicated when the benefits to either mother or fetus outweigh those of pregnancy continuation. Nitric oxide donors(NO donors) such as isosorbide mononitrate could be of a great use for cervical ripening because of their effect on release of prostaglandins and vasodilation while having no or little effect on uterine activity ; since they are relatively safe and has low number of non-vital adverse effect if used with caution, they could be added to misoprostol to shorten to time needed for cervical ripening thus accelerating the whole process of induction of labor.

The Aim of this study

was to evaluate safety & efficacy of nitric oxide donors such as intravaginal isosorbide mononitrate in addition to misoprostol versus misoprostol only for the whole process of induction of labor.

Patients and Methods

in a prospective randomized double-blind placebo-controlled clinical trial which was conducted at Ain Shams Maternity University Hospital in Cairo from January 2018 to June 2018, 50 women were included in induction of labor, they were randomly divided into 2 group: Group I consisted of 25 patients, each patient was given 1 tablet of isosorbide mononitrate 40mg vaginally once and one tablet of misoprostol 25mcg vaginally; Group II consisted of 25 patients, each patient was given 1 tablet of misoprostol 25mcg vaginally. Misoprostol were given for a maximum of 5 doses (one 25mcg vaginal tablet) with interval of 6 hours between each tablet. This clinical trial was registered in clinicaltrial.gov registry with number: NCT03523754.

Results

there was a statistically significant difference between Isosorbide mononitrate & Misoprostol group versus Misoprostol only group regarding induction to delivery time ( mean 19.55 ± 1.41 to 22.94 ± 1.44 hours respectively, P-value <0.001) , induction to active phase interval (mean 10.67 ± 1.83 to 13.81 ± 0.52 hours respectively, P-value <0.001), maternal headache (36% to 12% respectively, P-value =0.047).

Conclusion

Isosorbide mononitrate appears to be a safe agent when used with misoprostol for induction of labor. It decreases induction to delivery time and induction to active phase time.
Value of Ultrasonographic Guidance For Operative Hysteroscopy on the Safety and Outcome of the Procedure: Randomized Control Trial
Authors: Amer M I , Elbasuony W , Ali M A
Published: May 2020

Background

Hysteroscopy is a minimally invasive intervention that can be used to diagnose and treat many intrauterine and endocervical problems. Hysteroscopic polypectomy, myomectomy are just a few of the commonly performed procedures. Hysteroscopy has nearly replaced standard D&C for the management of abnormal uterine bleeding (AUB), as it allows for direct visualization and diagnosis of intrauterine abnormalities, and it often offers an opportunity for simultaneous treatment. Operative hysteroscopy is a safe procedure resulting in complication in 0.95-3% of cases. The most frequently observed complications include hemorrhage (2.4%), uterine perforation (1.5%), and cervical laceration (1-11%). Another rare complication is excessive fluid absorption with or without resultant hyponatremia. Can use of ultrasound guidance during operative hysteroscopy decrease the rate of the operative complication?

Objective

To assess the value of ultrasound guidance for operative hysteroscopy on decreasing the complication and improving the success rate of the procedure.

Patients and Methods

It is estimated that a sample size of 88 patients that were divided to 44 patients in the Ultrasound guidance group and 44 patients in the group that didn’t perform ultrasound. The patients were encountered from those presented at the gynecology clinic of the Ain Shams university hospital or those presented at ECDU with the inclusion criteria in the period between December 2017 to November 2018. The patients were approached to participate on study and a written informed consent was taken from all the patients.

Results

Comparative study between the 2 groups revealed; highly significant increase in success rate in ultrasound guided hysteroscopy (USH) group; compared to conventional hysteroscopy (CH) group; with highly significant statistical difference (p < 0.01) and non-significant difference as regards failure and complications rates (p > 0.05).

Conclusion

Our study found that ultrasound assistance for difficult hysteroscopy reported that ultrasound appears to be a safe and reliable method of assistance.
Subcutaneous Tissue Irrigation with Povidone Iodine in Decreasing the Rate of Surgical Site Infection Following Cesarean Section: (Randomized Control Trial)
Authors: Abdelrahman A H N , Samy M M , Shawky M E A , Azmy G A
Published: May 2020

Background

Cesarean section remains to be one of the most common surgical procedures performed worldwide and available data indicate that surgical interventions constitute approximately 0.4%–40.5% of all deliveries. Surgical site infections (SSIs) are reported to occur in up to 8.4% of women having a caesarean section (CS) with many negative effects, including pain, prolonged hospitalisation or readmission, need for antibiotics, return to theatre and increasing costs.

Objective

In women undergoing elective caesarian section, subcutaneous tissue irrigation with povidone Iodine may decrease the rate of surgical site infection.

Patients and Methods

The study included any female from 20 to 35 years old of gestational age 38 week or older with viable fetus, BMI 20-30 Kg/m2. Patient excluded were those with preoperative haemoglobin less than 10, prolonged rupture of membranes, diabetic, hypertensive or with any medical disorder including autoimmune diseases.

Results

The result of our study demonstrated that the use of povidone iodine 1% solution doesn’t have an added benefit in decreasing the incidence of SSI.

Conclusion

We conclude that the use of povidone iodine 1% solution in irrigation of subcutaneous tissue prior to skin closure in elective caesarian deliveries does not have an added benefit in decreasing the incidence of SSI and is, thus, not recommended at time being.
Hystroscopic cornual nerve block in operative hysteroscopy: a Randomized controlled trial
Authors: Amer M I , Abdelaleem M M , Elrefaey Y M
Published: May 2020

Background

Hysteroscopy has become a standard investigation for a lot of gynecological cases and found to be effective in detecting intrauterine pathology and treating it. It is usually performed as an outpatient procedure under either local or no anesthesia.

Aim of the Work

to assess the anesthetic efficacy of intracornual nerve block versus placebo in reducing pain & discomfort during operative hysteroscopy.

Patients and Methods

This randomized, double-blind, placebo-controlled study was conducted on 58 patients at the Early Cancer Detection and Endoscopy Unit (Ain Shams university Hospital) after taking Full ethical approval for the study. Patients referred for outpatient hysteroscopy (between march 2018 and December 2018) were informed about the possible role of intracornual nerve block in reducing pain that could be experienced during the procedure, and were asked to participate. Signed informed consent was obtained from all patients who agreed to participate in the study.

Results

Among the 42 women who underwent successful operative intervention, the visual analogue score for assessment of intra-operative pain was statistically significantly lower in the LA-ICOB group compared to the placebo-ICOB group. In the same context, the number of patients requiring extra analgesia (either as NSAIDs or opioid analgesics) was statistically significantly larger in the placebo-ICOB group compared to the LA-ICOB group.

Conclusion

This study proved that the use of intracornual nerve block in operative hysteroscopy is both beneficial and effective in reducing pain and discomfort that could associate operative hysteroscopy procedure.
Comparison between laparoscopic and vaginal suturing in closing the vaginal vault in Total Laparoscopic Hystrectomy
Authors: Fahmy A A , Labib K M , Elnahas M A
Published: May 2020

Background

Hysterectomy is defined as surgical removal of the uterus. It is one of the most gynecological operations all over the world. Benign diseases are responsible for more than 70% of the indications for hysterectomy. e.g: fibroids, pelvic pain and menstrual disorders.

Aim of the study

to

compare between laparoscopic route and vaginal route in vaginal vault closure in total laparoscopic hysterectomy.

Patients and Methods

This comparative study was carried out between March 2018 and October 2018, at Ain Shams maternity hospital and Helwan materinity hospital, a prospective randomized control comparative study of 32 ladies undergoing total laparoscopic hysterectomy after obtaining the approval of the local ethical committee and a fully-informed written consent.

Results

A total of 32 patients were included in the study and they were divided into 2 groups each group consisted of 16 patients, the first group of patients underwent laparoscopic suturing and the second group underwent vaginal suturing. Each group was further subdivided into vertical (8 patients) and horizontal (8 patients). Both groups were matched for age, parity, BMI, menstrual status, comorbidities, previous cesarean sections and indications for hysterectomy.

Conclusion

Vaginal vault closure can be performed safely and effectively both vaginally and laparoscopically.Vaginal route for vault closure was shorter and easier than laparoscopic route.Vaginal horizontal suturing was comparable to vaginal vertical. Laparoscopic vertical was easier and faster than laparoscopic horizontal.
Association between Letrozole Dose and Pregnancy Rate in Clomiphene-Resistant Women with Polycystic Ovary Syndrome Randomized Controlled Trial
Authors: Elhoussieny A S , Mohamed M E , Elkotb A M , Elsharnobi K R
Published: May 2020

Background

Among couples experiencing difficulty conceiving, unexplained infertility is a fairly common diagnosis, occurring in approximately 10–20% of cases. One of the options available to women with unexplained infertility is ovulation induction, which is most commonly achieved using clomiphene citrate.

Aim of the Work

To evaluate the effect of high dose letrozole protocol (7.5 mg, 10 mg for 5 days compared with standard letrozole protocol 5 mg for 5 days) in the management of clomiphene-resistant women with polycystic ovary syndrome.

Patients and Methods

Randomized controlled clinical trial. The current study was conducted in Ain Shams University Maternity Hospital. The study included a total of 120 women. The study population was randomized using a Computer generated randomization system into 3 groups: Group A: standard letrozole regimen (5mg /day starting from day 2 to for 5 days).

Group B

received letrozole (7.5 mg/day from day 2 for 5 days).

Group C

received letrozole (10 mg/day from day 2for 5 days).

Results

We found that there were insignificant differences between study groups as regard age, BMI and Duration of infertility p-value 0.997,0.873,0.927 respectively, there was insignificant differences between study groups as regard parity and Ovulation status p-value 0.575,0.897 respectively, there was insignificant differences between study groups as regard serum level of FSH,LH, E2 and Testosterone p-value 0.911, 0.821, 0.811, 0.954 respectively.

Conclusion

It seems that the use of higher doses of letrozole improve endometrial thickness and follicle number but it offers no advantage in terms of pregnancy rates over the lower (2.5 mg) dose.
Transverse Supraumbilical versus Pfannenstiel Incision for Cesarean Section in Morbidly Obese Women “A Randomized Controlled Trial”
Authors: Elsayed H M , Elmekkawi S F , Elkotb A M , Abdelhady R M , Elhossary H M A
Published: May 2020

Background

Cesarean section is one of the most common operative procedures performed in modern obstetrics, cesarean section is defined as the birth of a fetus through incision in the abdominal wall and the uterine wall. Obesity is currently the most prevalent health threat the world over and its influence on general health is rapidly increasing. Obesity has a dramatic impact on pregnancy outcome. Apart from an associated increased prevalence of diabetes and hypertension, obesity in pregnancy has been associated with poor perinatal and neonatal outcomes. Obese mothers have an increased risk of pregnancy complications such as anemia, hypertension, pre-eclampsia, preterm delivery, emergency cesarean section, and gestational diabetes and significantly increases the rate of cesarean section.

Aim of the Work

This study aimed to evaluate the efficacy and safety of transverse supraumbilical incision compared of pfannenstiel incision in morbidly obese women undergoing cesarean section.

Patients and Methods

This study was conducted in the casualties of Ain Shams University Maternity Hospital. Parallel, superiority randomized controlled trial with allocation ratios 1:1. All Participants 72 women will be randomly allocated into two groups; each group will be included 36 women, one group will be those who will undergo the transverse supraumbilical incision while other group will undergo pfannenstiel incision. Randomization will be performed in advance by computer using variable blocks the random number generator in MS Excel (Microsoft, Seattle, WA, USA).

Results

As regard risk analysis for the incidence of adverse outcomes TSU inicision is associated with significantly lower risk for wound complication compared with a pfannenstiel-type incision (RR = 0.19, 95% CI = 0.07 to 0.5, p-value=0.0008). The number needed to treat is 2.1 with a 95% CI ranging from 1.5 to 3.6. There is faster regain of intestinal motility in transverse supraumbilical incision compared with pfannenstiel incision. Mean post-operative hospital stay in transverse supraumbilical group was (2.4) hours while that of pfannenstiel group (2.9) hours with no significant difference.

Conclusion

The transverse supraumbilical incision showed definite advantages over pfannenstiel incision; being faster to preform, less blood loss, less post-operative pain, earlier regain of intestinal motility, earlier ambulation, shorter hospital stay. Another Aspect, being economic, saving more of the stuff’s time, utilizing less anesthesia and needing least instruments.
Assessment of Quality of Life in Advanced Non-Small Cell Lung Cancer Patients on Platinum-Based Chemotherapy Combinations
Authors: Abdelwahab S A , Tawfik A S , Mosalam N A , Ghazy E M E
Published: May 2020

Background

Lung cancer is the most commonly diagnosed cancer worldwide for both sexes. There are 1.8 million new cases in 2012 (12.9% of the total), 58% of which occurred in the less developed regions. The disease remains the most common cancer in men worldwide (1.2 million, 16.7% of the total) and the most common causes of cancer deaths worldwide for both sexes, estimated to be responsible for nearly one in five (1.59 million deaths, 19.4% of the total)

Aim of the Work

are to evaluate the effect of platinum-based chemotherapy combinations as a first line treatment on health related quality of life (HRQOL) in advanced NSCLC Egyptian patients and to assess tumor’s response to treatment and treatment toxicity.

Patients and Methods

A prospective, single arm clinical study, to evaluate the effect of palliative chemotherapy on advanced NSCLC patient’s health related quality of life before starting chemotherapy and after 3 cycles of treatment, patient’s response to treatment and toxicity related to treatment.

Results

61 patients completed the EORTC QLQ-C30 and the QLQ-LC13 for the evaluation of HRQoL before the 1st cycle of chemotherapy. Started with 70 patients, 9 were excluded during the study (because of a change in the chemotherapy protocol or because of treatment discontinuation during the following cycles of chemotherapy.

Conclusion

The present study explored self-reported quality of life in advanced NSCLC patients receiving chemotherapy, Aiming for a better understanding of how chemotherapy influences HRQoL. The importance of patient perception of their own health regarding the complexity of cancer, which is a disease that affects every dimension of life and the way in which individuals perceive the environment, the diagnosis, and the therapy. Therefore, the combination of periodic quality of life assessments and clinical practice should be more extensively.
Retrospective analysis of clinico-epidemiological factors and clinical outcome in patients with urinary bladder carcinoma
Authors: Elsheikh E M , Ibrahim D R D , Abdelrahman O M , Ali H M
Published: May 2020

Background

Bladder cancer ranks ninth in worldwide cancer incidence and it is the second most common malignancy among Egyptian males. Urothelial carcinoma (UC) of the bladder (previously known as transitional cell carcinoma; TCC)is the predominant histologic type, the two most well-established risk factors for bladder are cigarette smoking and occupational exposure to urothelial carcinogens.

Aim of the Work

To analyze retrospectively the clinico-pathological features of urinary bladder cancer patients treated in Clinical Oncology Department of Ain Shams University Hospitals in Egypt.

Patients and Methods

All 127 eligible patients fulfilling the inclusion criteria and the medical sheets were reviewed including history, clinical examination, routine laboratory tests, radiological investigations, and follow up. Several prognostic factors were analyzed in our study including age, sex, performance status, tumor size, site, grade, extent of surgery and type of treatment as regard chemotherapy and radiotherapy.

Results

Among the included 127 patients, populatge ranged from 30 to 75 years. Males represented 81.9 % of the patients with a male to female ratio of 4:1. Eastern Cooperative Oncology Group (ECOG) performance status of patients at presentation was ECOG 1 in 82 patients (64.6%). The majority of the studied population presented with haematuria. The most common histological subtype in biopsied specimens was transitional cell carcinoma in 75.5% of the patients.78 patients presented with non-metastatic and 47 patients with metastatic urinary bladder cancer. The median progression-free survival (PFS) was found to be 17 months and similarly the median overall survival (OS) was 17 months. In our study we found a significant correlation between age, performance status (PS), smoking, tumor stage and the treatment modalities such as surgery and adjuvant chemotherapy with the overall survival.

Conclusion

The epidemiology of bladder cancer was dramatically shifted in Egypt with a lower incidence of squamous cell carcinoma (SCC), a greater incidence of TCC and older age at diagnosis. Age, PS, smoking, tumor stage and the treatment modalities such as surgery and adjuvant chemotherapy were proved to affect the overall survival.
Correlation of Outcome of Neo adjuvant Concurrent Chemo radiotherapy with Clinico-epidemiological characteristics in locally advanced rectal cancer patients: retrospective study
Authors: Abdelaziz H M , Ghali R R , Mosalam N A , Elnemrawy W A
Published: May 2020

Background

The treatment of (LARC) is subject to continuous change due to better diagnostic tools, radio therapeutic techniques and chemotherapeutic agents. It is clear, that a multimodality approach is the only way to achieve satisfactory local recurrence and survival rates in this type of cancer. Widespread use of neoadjuvant therapy have all contributed to decrease the rate of local recurrence, raise the quality of life and the probability of overall survival.

Aim of the Work

to correlate clinico-epdemiological factors of locally advanced rectal cancer patients with outcomes of neoadjuvant concurrent chemo radiotherapy (NACRT) regarding disease -free survival (DFS) and overall survival (OS).

Patients and Methods

In this retrospective study, data were collected from files of 100 patients with locally advanced rectal cancer patients with cT3-4 or any cT/cN+ disease assessed using colonoscopy, enhanced computed tomography. and or magnetic resonance imaging, between Jan 2010 and December 2016 in oncology department of Ain Shams faculty of medicine and Nasser institute of treatment and research. The patients received long course radiotherapy (45-50.4 Gy/1.8-2 Gy) combined with concurrent chemotherapy. Surgery was done after NACCRT.

Results

This study is no statistically significant difference between patient’s demographic characteristics with DFS and OS. This study shows there was no statistically difference between doses of long course radiation on DFS of the study and so type of concurrent chemotherapy on DFS while type of surgery had impact and statistically significant difference on DFS and OS. The study also showed that Types of surgery, y-pathological nodal staging had statistically significance with DFS and OS.

Conclusion

assessment of LARC patients before selection type of therapy is very important. Neoadjuvant concurrent chemo-radiotherapy is only stander of cure in high-risk group of LARC patients.
Prevalence of Ophthalmological Manifestations of MS
Authors: Elsamman N H , Gaafar A A , Zamzam D A , Elbayomi A M
Published: May 2020

Objective

The aim of this study is to highlight the neuro-ophthalmic manifestations and their correlation with visual dysfunction in patients of multiple sclerosis (MS).

Patients and Methods

One hundred patients diagnosed with MS according to the Revised McDonald’s Criteria of 2010 from the MS Unit at Ain Shams University Hospitals were included in the study from May to September 2017. A detailed medical history was taken and full ophthalmic examination was done to all patients including best corrected visual acuity (BCVA), pupillary reflexes, ocular motility, confrontation test, contrast sensitivity (CS) test, color test, slit-lamp biomicroscopy and dilated fundus examination.

Results

Acute ON was the first manifestation of the disease in 36% of patients and in 44% it occurred during the course of the disease. Although most patients’ visual acuity recovered to baseline after an episode of optic neuritis (ON), residual deficits in CS are common. Acute ocular motor manifestations were reported in 6 patients (6%) as a presenting symptom of MS. During the course of the disease 31 patients (31%) had at least one attack of acute abnormal eye movement. One patient (1%) among the studied group had anterior uveitis. There is a statistically significant correlation between CS in patients with no ON relapses and patients with at least 1 relapse (P value= 0.005). There is a statistically significant correlation between relative afferent pupillary defect (RAPD) in patients with no ON attacks and patients with at least 1 relapse (P value= 0.032). Also there is a statistically significant correlation between disc pallor in patients with no ON relapses and patients with at least 1 relapse (P value= 0.007). There is a statistically significant correlation between number of relapses of ocular motor symptoms and visual function impairment; BCVA (P = 0.025), CS (P = 0.027) and color vision (P = 0.039).

Conclusion

Our study emphasizes the high prevalence of ophthalmic manifestations among MS patients and that optic neuropathy is the most common manifestation. Detection of these symptoms and signs during ophthalmologic evaluation may lead to early diagnosis and treatment of MS that offer better outcome for those patients.
Role of Optical Coherence Tomography Angiography in the Diagnosis and Management of Wet Age-Related Macular Degeneration
Authors: Zaher F M , Metwally M G , Aziz B F , Abdelwadood Y Z
Published: May 2020

Background

Neo-vascular age-related macular degeneration (nAMD) (an advanced form of macular degeneration) is the main cause of visual impairment in older adults related to AMD. WHO has estimated that approximately 8 million people will be affected by AMD by the year 2020. Optical coherence tomography angiography (OCTA) is a novel imaging modality that permits direct visualization of the retinal and choroidal vasculature in vivo. In OCTA, high-frequency and dense volumetric scanning are made to detect blood flow by analyzing the signal decorrelation between scans. Compared with stationary areas of the retina, the movement of erythrocytes within a vessel makes a decorrelated signal. Unlike traditional angiography, OCTA does not necessitate the use of exogenous dyes, so avoiding potential side effects, such as nausea or other more serious adverse events. However, the role of OCTA as a diagnostic tool has not been largely investigated. Particularly, very few clinical studies have assessed the accuracy of OCTA imaging for the diagnosis of nAMD.

Aim of the Work

To highlight the benefits of using OCT-A in the diagnosis and management of wet AMD and compare it with the conventional angiographic standard, fundus fluorescein angiography (FFA).

Subjects and Methods

An interventional prospective comparative study will be conducted on 40 eyes diagnosed with wet AMD. Optical coherence tomography angiography and FFA will be done for all eyes. Analysis of the data obtained from the OCT-A will be done and compared with the standard FFA.

Conclusion

AMD is the leading cause of vision loss. Early detection and treatment is required. AMD is diagnosed by fundus examination, FA, and OCTA. OCTA and FA imaging provide complementary information about pathological changes in chorioretinal diseases. OCTA is highly sensitive for identifying AMD, CNV, and CNV activity; however, it cannot fully replace FA in the diagnosis of AMD.
Assessment of Corneal Epithelial Thickness in Chronic Contact Lens Users Using Anterior Segment Optical Coherence Tomography
Authors: Rezk A A M E A , Assaf A , Gamil M , Badran T
Published: May 2020

Introduction

The corneal epithelium is stratified epithelium that is continuously renewed and provides the frontline of defence against invading ocular pathogens and a smooth refractive surface essential for vision. In the absence of a contact lens, pre-existing ocular trauma or disease, the epithelium maintains an inaccessible defence against attacks from pathogenic microorganisms, affording a high level of resistance against microbial invasion.

Aim

The aim of this study is to determine the effect of chronic use of contact lens on corneal epithelium thickness using anterior segment optical coherence topography as a non- invasive diagnostic accurate measure.

Patients and Methods

30 eyes of control subjects who don’t wear contact lens along their life aged between 15-45 years ,where compared with similar age group of 30 eyes of chronic contact lens users; who wear contact lens every day not less than 8 hours per day for along time interval between 6 months up to 5 years.

Results

The average corneal epithelial thickness in the central, paracentral and midperipheral zones was 47.767 ± 5.550 µm, 46.267 ± 5.644 µm, 44.300 ± 4.858 µm, respectively, in chronic soft contact lens users; and 49.800 ± 3.316 µm, 49.200 ± 3.367 µm, 45.733 ± 2.333 µm ,in control group who had never worn contact lens. There were insignificant thinning of corneal epithelium of soft contact group compared to control group regarding the average corneal epithelial thickness in those 3 zones. In all the 8 sectors of corneal epithelium of paracentral zone and midperipheral zones there is insignificant thinning between the two groups except for the inferior temporal sector in the paracentral zone and mid peripheral zone, which shows significant thinning in soft contact lens group compared to control group. The corneal epithelial thickness in the inferior temporal sector of paracentral and mid peripheral zones was 46.333 ± 5.677 µm, 44.933 ± 4.813 µm, respectively, in chronic soft contact lens users compared to 48.767 ± 3.266 µm, 46.900 ± 2.510 µm in control group (p = 0.046, p = 0.052, respectively).

Conclusion

AS-OCT helps us to evaluate the corneal epithelium of contact lens users, which could be very useful in corneal refractive surgeries in patients depending on contact lens in their lives as a comfortable refractive aid, It is necessary to do AS-OCT hand on hand with pentacam in patients underwhelming refractive surgery to give a proper assessment to their corneal epithelium before determining which type of refractive surgery suits them.
Effects Occurring in Central Retina Detected by Optical Coherence Tomography before and after YAG Laser in Pseudophakic Patinets
Authors: Abdala B , Magdy K , Oreiby M M M E
Published: May 2020

Introduction

Cataract is a consequence of the ageing of the lens and is the major priority in the global initiative to eliminate avoidable blindness by the year 2020. At present, the only means of treating cataract is by surgery, which initially restores high-quality vision and this is currently the most performed operation in developed countries.

Aim of the Work

to evaluate the influence of Nd:YAG laser capsulotomy on visual outcomes and macular thickness in patients with opacified posterior capsule.

Patients and Methods

This is a prospective comparative study done at the Nour Elein Hospital in Tanta. Thirty one pseudophakic eyes of patients (seven male, twenty four female), were included in the study with PCO following uncomplicated phacoemulsification with posterior chamber intraocular lens implantation. The age ranged from forty six years to sixty seven years old with a mean of (63.32±5.67) years. An informed consent was taken from each patient. All patients were treated by Nd: YAG laser capsulotomy between January 2017 till December 2017. The average time after cataract surgery was 18 months.

Results

Both groups had increased macular thickness at 1 week after Nd:YAG laser capsulotomy. The degree of macular thickening was similar in group 1 and group 2. Mean macular thickness was decreased to preoperative levels at 4 weeks after Nd:YAG laser capsulotomy in both groups volume.

Conclusion

Nd: YAG laser capsulotomy is the standard treatment for PCO and gives rise to rapid improvements in visual acuity, relieving the symptoms of blur, photophobia, and glare, and the size of capsulotomy opening does not affect the improvement in visual acuity, but it is better to avoid small sized capsulotomies to avoid post capsulotomy difractions.
Correlation between Retinal Nerve Fibre Layer Thickness and Glycosylated Haemoglobin in Non Proliferative Diabetic Retinopathy
Authors: Lotfy Alshaimaa M , Saad A H , Mohamed T H , Elzankalony Y A
Published: May 2020

Background

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglyaemia. Diabetes cause many complication. diabetic retinopathy is common complication which affects up to 80 percent of all patients who have diabetes for more than10 years or more. Retinal functional abnormalities as reduced contrast sensitivity and ERG abnormalities could be detected in diabetic patients before microvascular lesions can be detected in ophalmological examination.

Purpose

to determine correlation between retinal nerve fibre layer thickness measured by Optical coherence tomography and glycosylated haemoglobin in type 2 non proliferative diabetic retinopathy.

Patients and Methods

In our study was conducted on patient recruited from National institute of Diabetes and endocrinology in the ophthalmic clinic. Patients were evaluated for peri-papillary retinal nerve fibre layer ( RNFL) thickness by optical coherence tomography (RS 3000 advance). Blood were taken for HbA1c. The study was included 164 eyes from 87 patients. The patients were non proliferative diabetic retinopathy(NPDR) classified into three groups according to Early Treatment Diabetic Retinopathy Study into; Mild group was 69 eyes from 35 patients, moderate group58 eyes from 31 patient, Severe group 37 eyes from 21 patients.

Results

The severe group show statistically significant difference with the others (P < 0.001) except with mild group in nasal and inferior quadrant, therefore the thickness was high in the severe groups because the edema in RNFL. In our study we observed decrease in total thickness of RNFL in peripapillary area. However, among each quadrant we observed that the superior quadrant was thinner compared to other quadrants (p < 0.001). There was insignificant correlation between RNFL thickness with the Glycosylated haemoglobin ( HbA1c )in all NPDR groups.

Conclusion

Early NPDR patients appear to have thinner RNFL thickness and severe NPDR patients show increasing RNFL thickness. There are not correlation between RNFL thickness and glycosylated haemoglobin.