bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum Anandamide for Assessment of Non Alcholic Fatty Liver Disease Severity
Authors: Mohamed Ismail Salah Tharwat , El Sayed Ashour Engy Yousry , AL-kilani Hesham Hamdy , EL-hamid Rafaat Khalid Abd
Published: November 2024

Background

Nonalcoholic fatty liver disease (NAFLD) is a very common disease, ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) and is considered the hepatic expression of metabolic syndrome. Liver biopsy is currently considered the gold standard in diagnosis of NAFLD; however, it is an invasive technique and carries many risks. The serum anandamide level is recently discovered to play an important role as the potential indicator for NAFLD severity. The purpose of the study is to determine the association of endocannabinoid metabolite anandamide and NAFLD severity and to investigate its association with anthropometric and metabolic features in NAFLD patient.

Aim of the Work

To find a Correlation between serum anandamide and NAFLD severity.

Patients and Methods

A case–control study on 30 NAFLD biopsy-proven NAFLD patients and 30 healthy volunteers. This study was carried out at Outpatient Clinics of Gastroenterology department at Ain Shams Hospital from September 2021 till September 2022. They were subjected to full clinical history and examination, laboratory tests, abdominal ultrasound and serological testing of anadamide.

Results

The mean liver profile test in both groups were within the normal level except for the AST and ALT level in which in the patient group statistically significant (p = 0.01) in AST. On measuring the lipid profile between both groups there is statistically significant differences in the cholesterol and triglyceride level between both groups. The anadamide level was significantly higher among NAFLD groups vs. the normal group (P value 0.01) with cutoff > 0.215 in the NASH group (accuracy 88.3%; sensitivity 76.7% and specificity 100%). Serum anandamide has positive correlation with NAS score (r = 0.402). Our analysis identified AEA as a candidate biomarker for NASH. Obesity and diabetes are risk factors that contribute to the increasing prevalence of hepatic steatosis and NAFLD.

Conclusion

The serum anandamide level is more higher in patients with NAFLD than control group with statistically significant difference, we also found positive correlation between S. anandamide level and NAFLD activity score (NAS).
The Effect of Omega-3 Fatty Acids versus Gabapentin in Uremic Pruritus in Hemodialysis Patients. Randomized Controlled, Cross-Over Clinical Trial
Authors: Teama Nahla Mohamed , Shawky Sahar Mahmoud , Ibrahim Mona Abdel-Halim , Khalifa Sara Abd El-Naby Mohammed , El-Mobdy Ashraf Hassan Abd
Published: November 2024

Introduction

One of the most annoying, common, and even incapacitating issues for people with chronic kidney disease (CKD) is uremic pruritus. However, the lack of essential fatty acids is a significant area of etiological concern in connection to uremic pruritus. It appears that giving ESRD patients more necessary fatty acids and their derivatives may have a number of good effects on their physiological characteristics and cellular membrane structure. Omega-3 fatty acids have anti-inflammatory benefits for many inflammatory disorders. Abundance of Omega-3 fatty acids has been proven to be useful in the reduction of pruritus. So, we aimed in this study to evaluate the effect of Omega – 3 fatty acids versus Gabapentin in uremic pruritus in hemodialysis (HD) patients.

Methods

In a randomized controlled trial, we enrolled 50 prevalent HD patients recruited from the HD unit at Ain Shams University Hospital. Patients were randomly assigned to two arms: Group A: Included 25 patients who received Omega-3 added to the traditional treatment (Calcium, erythropoietin stimulating agent). Patients received treatment for four weeks, then after washout period (6 weeks) on traditional treatment only then Gabapentin was given. Group B: Included 25 patients who received Gabapentin added to the traditional treatment (Calcium, erythropoietin stimulating agent). Patients received treatment for four weeks then after washout period (6 weeks) on traditional treatment only then Omega-3 was given.

Results

PGE2 was significantly reduced among patients treated with Omega-3 compared to Gabapentin. 5-D itch scale was significantly reduced among all patients after treatment with Omega-3

Conclusion

We have demonstrated that Omega-3 fatty acids are not less effective than Gabapentin in decreasing uremic pruritus. It seems that Omega-3 fatty acids could be used as an efficient drug for the treatment of pruritus in uremic patients.
Measurement of Serum and Fecal Calprotectin in Egyptian Ankylosing Spondylitis Patients
Authors: Ahmed El-Azizi Noran Osama , Aly Hussein Safaa Abdelsalam , Ahmed Maha , El-Serwy Ahmed , Kamel Khodary Zainab Abdou
Published: November 2024

Background

Axial spondyloarthropathies are chronic, often progressive, inflammatory disorders of the axial skeleton including the sacroiliac joints. Patients suffer from pain, fatigue, limited spinal motility, functional disability, and impaired psychological wellbeing AS has many extra-articular manifestations, it has been concluded 4-6% of patients with AS have symptomatic inflammatory bowel disease.

Objective

To estimate role of serum and/or faecal calprotectin in ankylosing spondylitis disease activity, especially in patients with intestinal symptoms.

Methods

This was a cross sectional study which was done on 40 ankylosing spondylitis patients diagnosed according to history, clinical examination and laboratory data according to ASAS classification criteria of ankylosing spondylitis 2009.

Results

Our study revealed that there was a positive relation between serum/ fecal calprotectin and disease activity according to ASDAS-CRP. Most of the patients with positive serum and fecal calprotectin had high disease activity with percentage of 56.2% (p-value=0.008) and 54.8% (p- value=0.026) respectively. Hemoglobin levels were lower among patients with positive serum and fecal calprotectin levels which was of statistical significance with p-value of 0.002 and 0.016 respectively. Also, hemoglobin level was affected by the Prescence of GIT symptoms being lower among patients with GIT symptoms with p-value 0.025. ESR level was higher among patients with positive serum and fecal calprotectin levels which was of statistical significance with p-value of 0.036 and 0.032 respectively.

Conclusion

Serum calprotectin was more sensitive and specific than fecal calprotectin as a biomarker for disease activity in Egyptian ankylosing spondylitis patients. There was a positive relation between serum/fecal calprotectin and disease activity. There was a negative relation between serum/fecal calprotectin and hemoglobin level. The most common gastrointestinal symptoms among Egyptian ankylosing spondylitis patients were abdominal pain and constipation.
Effect of Childhood Epilepsy and Antiepileptic Drugs on Visual Evoked Potential Response and Optical Coherence Tomography
Authors: ElDen Ahmed Nahed Salah , Nassef Ayman Mohamed , Nada Maha Ali , Ibrahim Shaimaa Said , Said Abd El Karim Marwa Ahmed , Moussa Amira Ahmed
Published: November 2024

Background

The experience of evoked potentials in patients with epilepsy is sparse. Earlier studies in the literature, especially during the 1970s and 1980s, were conducted in previously treated epilepsy patients primarily to investigate drug effects or drug toxicity on afferent nerve conduction within the central nervous system.

Aim of the Study

to investigate effect of idiopathic childhood epilepsy per se on VEP and OCT and effect of two antiepileptic medications on them and correlate that with clinical symptoms if present.

Patients and Methods

this is a biphasic study, 1st one is case control and 2nd phase is a controlled clinical prospective trial, conducted in the neuro-pediatric outpatient clinic of Ain Shams University. This study enrolled 50 epileptic children drug naïve and 50 age and sex matched healthy controls, both groups were subjected to pattern reversed visual evoked potential and only 28 of the patients and 28 of the control group were subjected to ocular coherence tomography, starting from March 2021. The 50 patients were divided into 2 groups, the first one enrolled 23 patients that received levitracetam and the 2nd one enrolled 27 patients that received valproate. Both groups were followed up over 24 months and follow up VEP and OCT done to compare the two groups and correlate with the baseline parameters.

Results

66% of the patients’ group was boys while 34% were girls, with mean age 10.5± 3.47. By measuring VEP in the two groups the mean P100 latency in the right eye and the left one of the control group was 110.4±3.76ms and 111.25±3.92ms respectively while in the patients group was 114.94±12.81ms and 115.37±11.88ms respectively that showed significant difference between the two groups with p- value 0.020 and 0.023 respectively.

Conclusion

there was prolonged latency in the epileptic children before starting AEDs more than the control group. This means that there was a disruption of the neural circuit by the epilepsy due to disruption of gabamenergic neurotransmitter system which plays an important role in mediating responses of cells in the visual cortex and retina and assists in shaping the receptive fields of the pyramidal cells in the superficial layers of the occipital cortex.
Integrity of Brainstem Vestibular Connections in Patients with Essential Tremor
Authors: Ali Shalash Ali Soliman , Mansour Alia Hassan , Mahmoud Eman Mones , Ibrahim Weheiba Hoda Mahmoud , Zaki Elkordi Aya Abdelhamid
Published: November 2024

Background

Essential tremor (ET) is the most common adult movement disorder, affecting about 4.6% of those aged 65 years and older. Recent studies have also demonstrated an association between ET and hearing impairment. Although different neuroanatomical structures and pathways are emphasized as possible explanations for essential tremor (ET), there is still an ongoing debate. This study aimed to assess the role of brainstem auditor responses and reflex pathways with ABR & vestibular-evoked myogenic potentials (VEMP) in patients with ET.

Aim of the Work

1. To assess peripheral & central vestibulocochlear function in patients with ET in comparison to controls & To correlate the degree of vestibulocochlear and brainstem pathway dysfunction to disease characteristics and severity.

Patients and Methods

24 patients were included, selected from outpatient clinics at recruited from movement disorders clinic at Ain Shams University Hospitals and fulfilled the criteria of diagnosis of ET (ET criteria were set forth in the Consensus Statement of the Movement Disorder Society) (Bhatia et al. 2018) and 24 healthy controls who were age and sex matched, selected from workers at outpatient clinic, Fahn Tolosa tremor scale (FTM) was used for assessment of severity of tremors in patients, in addition ABR parameters were recorded for both groups for assessment of upper & lower vestibular pathways.

Results

Our study showed that there was non-significant difference as regards the age and gender between the two groups, on the other hand there was significant difference between the patients and controls regarding prolongation of wave III & V latencies than healthy controls, with statistically significant positive correlation between wave length and the severity of tremor (p = 0.015).

Conclusion

The findings in our study highlight the involvement of vestibular pathway by utilizing the vestibular studies which justify the increasingly noticed hearing impairment in ET patients population & help us to further understand the pathophysiology of ET.
Quality of Life of Spinal Muscular Atrophy Patients Treated with Intrathecal Nusinersen before and during Treatment
Authors: Fahmy Nagia Aly , Hamdy Nabila , Taher Hany , Soliman Radwa Mohamed , Mekawy Aya Mohamed Amin Mohamed
Published: November 2024

Background

Spinal Muscular Atrophy (SMA) is one of the most common congenital neurodegenerative diseases with prevelance of 1-2 per 100,000 persons and incidence of 1 per 10,000 live births for all SMA types combined. This year, fourteen Egyptian chromosome 5q-related SMA patients had the chance to receive the medication Nusinersen under governmental aid. That is a great opportunity as the most limiting factor of receiving any of the three FDA approved treatments for SMA is still the tremendous financial burden.

Objective

To compare the total quality of life of the first Egyptian patients receiving the therapy in Cairo and also observe the progression of the eight domains of the 36 short health survey questionnaire. This is to assess the subjective changes on individuals during the first six months from course of medication.

Methods

Prospective longitudinal Pilot study in which each patient’s quality of life is measured in a quantitative form before receiving Nusinersen intrathecal injections and compared to the results after two months and six months of receiving regular Nusinersen therapy according to the standard protocol of injection of the medication. Patients were recruited from Ain Shams University Hospitals within a period of 6 months and they received the intrathecal injections of Nusinersen therapy in Nasser Institute Hospital of Research.

Results

By using 36-short form health survey, there is a statistically significant increase in total quality of life (Qol) with continuous elevation between the first loading doses completed at two months and first maintenance dose at six months. In regards to our results, we assume that the treatment Nusinersen would be of benefit in increasing the quality of life of SMA patients.

Conclusion

Nusinersen showed rapid positive alteration in the quality of life of recipients improving not only the motor functions of patients but rather enhancing many other aspects of their lives such as energy levels, pain during daily activities, social functioning and role limitations. This leads to an overall improvement of their quality of life in a statistically significant manner only in a relatively short period of time.
Predictors of Disability and Disease Progression among a Sample of Multiple Sclerosis Patients: An Egyptian Study
Authors: Ali Hagar Saad , Ahmed Nasef Ayman Mohamed , El Nabil Lobna Mohamed , Fouad Mohamed Mahmoud , Sayed khater Shaimaa
Published: November 2024

Background

Diagnosing secondary progressive multiple sclerosis (SPMS) requires careful examination of the gradual decline that occurs following an initial relapsing-remitting multiple sclerosis (RRMS) course. Unfortunately, a lack of definitive criteria for determining when RRMS transitions to SPMS poses a challenge to accurately studying the differences between the two stages of the disease.

Objective

In this study, we aim to discover the potential predictors of disability and disease progression in Egyptian multiple sclerosis (MS) patients.

Methods

This retrospective hospital-based cohort study included 3123 patients diagnosed with multiple sclerosis (MS) - according to the revised McDonald criteria 2017- recruited from the registry of the MS unit at Ain Shams University over 2 years; and their demographic, clinical, and MRI data were collected.

Results

during the study period; 213 (6.82%) patients were found to be SPMS, and 17 of them dropped out during the study. Females represented 132 (67.35%), the mean age at the onset of the disease was 26.75 ± 8.4 (SD) years. While the mean duration of illness was 16.11 ± 7.49 (SD) years. The mean EDSS of the patients was 6.056 ± 1.36 and the mean number of relapses in the first 2 years was 2.95 ± 1.67 (SD) years. The number and types of MRI lesions both at baseline and last available one (T2, T1 black holes) in the different anatomical locations (FLAIR) (periventricular, juxtacortical, infratentorial, and spinal) were correlated with the clinical and demographic data of the patients as well as with the EDSS score. The presence of periventricular and spinal cord lesions and brain atrophy at baseline were significantly correlated to high EDSS scores (P < 0.001, P = 0.038 and P = 0.002) respectively. Also, the number of T2 lesions more than 10 was significantly correlated to the progression of the EDSS scores (P = 0.007) after linear regression analysis.

Conclusion

This study showed that the predictors of disability and disease progression in Egyptian MS patients include male gender, higher age at the onset of disease, increased number of disease relapses in the first 2 years, the presence of spinal cord lesions, brain atrophy, and more than 10 T2 lesion at the baseline MRI.
Assessment of Anxiety, Depression and Fatigue as Prodromal Symptoms that May Precede Multiple Sclerosis First Demyelinating Event or Symptom Onset
Authors: Nasef Ayman Mohamed Ahmed , Awad Eman Mahmoud , Abousteit Alaa Mohamed Sayed , Ibrahim Shaimaa Sayed , Hussein Kareem Abd Elhamed
Published: November 2024

Background

Multiple sclerosis (MS) is a neuroinflammatory and neurodegenerative condition that led to chronic neurological disability in adults.it is characterized by multiple remissions and relapses that eventually lead to the neurological disability.

Aim of the Work

In this study we assessed the prodromal period through assessing only patients recently diagnosed with multiple sclerosis and was done through specific scales in order not to miss mild cases or vague complains.

Patients and Methods

This study is a cross sectional study, starting from November 2022 till April 2022 attending to ASU- neurology department – MS unit. Patients diagnosed with multiple sclerosis for the first time attending MS unit in neurology department.

Results

The demographic data had also no statistically significant relation to the prevalence of main symptoms of fatigue, depression and anxiety among the studied sample which was similar to the studies assessing the prodromal symptoms in MS patients yet with limited assessing of the demographic data to only age and gender. Prevalence of fatigue among the sample came higher than the overall prevalence of fatigue in the general population and higher than the overall prevalence of fatigue symptoms in the outpatient clinics which could mount fatigue symptoms to be further studied as possible marker of multiple sclerosis yet could also be linked to the much larger sample size used in those surveys and different methods of assessment. Prevalence of depressive symptoms came out to be higher than the overall prevalence of depression worldwide and the overall prevalence of depression in Egyptian population which could mount the mood symptoms to be further assessed as prodromal factors yet with the same risk of bias for the much larger sample size used in those surveys and the different assessment method. Prevalence of anxiety symptoms came out to be higher than the overall prevalence of anxiety worldwide and higher than its prevalence in Egyptian population which could also mount the subject to be presented as future factor for the prodromal period of multiple sclerosis yet with the same factors of bias as mentioned before of much larger sample size and different assessment methods.

Conclusion

In our study the assessed symptoms of fatigue, anxiety and depression have had higher prevalence in recently diagnosed MS patients before their diagnosis than the reported prevalence of these symptoms worldwide and in the Egyptian population. According to the results these symptoms could mount to be further studied on larger scale as prodromal risk factors trying to remove any possible risk of bias in association with assessment of other symptoms signs and investigations.
Efficacy of Ultrasound Guided Sphenopalatine Ganglion Block versus Greater Occipital Nerve Block in Management of Chronic Migraine
Authors: Abdulghani Mohamad Osama , Reda Ramez , Hussein Tamer , ElSadek Ahmed Mohammed , Mohamed Sherien , Abdelmohsen Taha Nourhan
Published: November 2024

Introduction

Migraine is a common primary headache disorder, announced as the second largest contributors of disability-adjusted life-years in the Global Burden of Disease Study. However, different treatment modalities have emerged for migraine including ultrasound guided sphenopalatine ganglion block and greater occipital nerve block, but there weren’t enough studies that compared their efficacy to each other, despite showing efficacy against medical treatment in different types of headaches.

Materials and Methods

This study was a two-arm randomized controlled trial, included 40 patients, 20 in each arm, randomized by simple randomization, all patients were assessed initially by headache diary, HIT-6 and MIDAS scales. The patients underwent nerve block ultrasound guided, then followed up after one month by headache diary and HIT- 6 scale and three months by MIDAS.

Result

This study showed significant improvement in the two arms, with significant difference between both groups as regards the improvement, with SPG block showing better improvement.

Conclusion

This study highlighted the efficacy of nerve blocks in treatment of chronic resistant migraine, with SPG block showing promising response. This study recommends extending the study to involve a larger scale of patients to approve the efficacy of nerve blocks in such cases.
Frequency of Silent Lacunar Cerebral Infarction in Patients with Type 2 Diabetes Mellitus
Authors: Ibrahim Mohamed Hamdy , Mahmoud Afify Hossam El-din , Zaky Omar Ahmed , Ali Eltawab Nourhan Fekry , Khaled Elewa Mohamed
Published: November 2024

Background

Diabetes mellitus type II causes different stroke subtypes, particularly lacunar stroke. Most cerebral lacunar infarctions do not cause a neurological deficit. So, they are called “clinically silent”.

Objectives

We aimed to study the frequency of silent lacunar cerebral infarctions in patients with Type II diabetes mellitus and to identify patients’ demographic, laboratory, and imaging characteristics.

Patients and Methods

This Cross-sectional study was conducted at the Internal Medicine Department of Ain Shams University Hospital, and included 92 patients diagnosed with type II diabetes mellitus according to the American diabetes association’s 2021 criteria. Participants underwent comprehensive physical and neurological examinations to detect the presence of any subtle neurological signs, as well as HbA1c and lipid profiles. Brain imaging, with the Philips Achieva 3 Tesla MRI scanner, was utilized to detect silent cerebral lacunar infarctions.

Results

Silent cerebral lacunar infarctions were detected in 92.4 % of patients (85/92 patients) predominately in the Corona radiata, Centrum semi-oval, and subcortical areas including the Basal ganglia, Pons, and Thalamus.

Conclusion

Asymptomatic patients with Type II diabetes mellitus could have vascular cerebral changes without neurological symptoms. Brain MRI scanning can be recommended as a routine investigation in neurologically asymptomatic type 2 diabetic patients who have a mean age of 56.8± 7.86 years old, and duration of illness above 10 years, especially males, regardless of HbA1c and lipid profile levels, to detect early vascular ischemic changes.
Clinical Characteristics of Egyptian Patients with Active Secondary Progressive Multiple Sclerosis
Authors: Salah Soha Ahmed , Zakaria Magd Fouad , Abd El-Aziz Azza Abd EL-Nasser , Fouad Mohamed Mahmoud , El-Hafeez Mohamed Ali Abd
Published: November 2024

Background

Many challenges exist in the precise definition of secondary progressive multiple sclerosis (SPMS). Early diagnosis of active SPMS is getting more important as pharmaceutical treatment options are developed.

Objectives

This study aimed to assess the clinical characteristics of patients with active SPMS enrolled in a new registry in Egypt and compare it with 6-month follow-up assessment.

Methods

It is a longitudinal, hospital-based study, conducted in the multiple sclerosis unit of Ain Shams University Hospital, forty-six patients were enrolled in this study who fulfilled the 2017 McDonald criteria for MS, as well as that of active secondary progressive multiple sclerosis (SPMS). All patients are subjected to a full personal history, primary clinical assessment was done using EDSS, Symbol Digit Modalities test (SDMT), and timed 25-Foot Walk Test (T25FWT) and were followed up and compared by a 6-month assessment.

Results

The mean age of the studied group was 43.543 ± 8.326 (SD). Females represented 69 %. The mean age of MS onset was 29.565 ± 8.010 (SD), mean age of SPMS onset was 40.109±7.892 (SD). EDSS mean value at baseline assessment was 5.8 and increased to 6 in the 6-month follow-up with a significant difference between the two assessments (p < 0.001). SDMT mean value in baseline assessment was 24 and deteriorated to 21 in the 6-month follow-up. With p-value <0.001. Regarding T25FWT baseline mean value was 16 seconds and increased to 18 seconds during the 6-month follow-up with a significant p-value of 0.013.

Conclusion

This study showed the importance of highlighting other aspects than motor to detect progression in patients with MS and the importance of entangling different techniques for better and more accurate assessment and earlier detection of progression.
Perceived Parenting Styles and Parental Bonding among a Sample of Adolescents Attending Adolescents’ Psychiatry Clinic at Ain Shams University Hospital
Authors: Sayed Maha Muhammad , ElGhamry Reem Hassan , Hashem Reem Elsayed Mohamed , Mohamed Maryam Yahia , Awwad Yasmine Muhammad
Published: November 2024

Background

Although family history of mental disorders is one of the most consistent and potent risk factors for mental disorders in offspring, both familial and non-familial environmental factors are thought to play a role in etiology. Many aspects of parenting, ranging from daily interactions to potentially traumatic experiences such as abuse and inter-parental conflict, may be not only mechanisms through which parental disorders confer increased risk to offspring but also independent risk factors for mental disorders.

Aim of the Work

Our study aimed to study perceived parenting styles among adolescents with different psychiatric disorders compared to adolescents without psychiatric disorder, study both maternal and paternal bonding among adolescents with different psychiatric disorders compared to adolescents without psychiatric disorder.

Patients and Methods

Our study was conducted in Ain Shams university hospital, precisely in the outpatient clinic of Okasha institute of psychiatry. We compared 50 adolescents diagnosed with different psychiatric disorders to 50 healthy adolescents. Participants were recruited from the outpatient clinic while a matched group of adolescents without psychiatric disorders was recruited from adolescents of employee working in Okasha institute of psychiatry.

Results

adolescents with different psychiatric disorders perceived their parents as more authoritarian, less authoritative. they also perceived their mothers as less permissive, while there was no significant difference between both groups regarding father's permissiveness. Low level of care and high level of overprotection were significantly correlated with all psychiatric disorders in the study group.

Conclusion

Pathogenic parenting styles characterized by high level of control and overprotection and low level of care are associated with wide range of psychiatric disorders in adolescents, while parenting styles characterized by high level of care seem to be protective against psychiatric disorders in adolescents.
A Comparative Study of Post-Operative Outcomes with and without Using Intraoperative Neurophysiological Monitoring in Intra Medullary Spinal Cord Tumors Surgeries; A Systematic Review
Authors: Mustafa Hazem Ahmed , Hamada Salah Mustafa , Ashour Ahmed Maamoun , Emam Abdelrahman
Published: November 2024

Background

Although relatively infrequent, neurological injury is a much dreaded complication in spine surgery and has the potential to result in serious postoperative motor and sensory deficits. As a result of these surgical challenges, intraoperative neuromonitoring (IONM) has gained favorable grounds in facilitating maximal tumor resection and minimizing neurologic morbidity.

Aim and Objectives

to review the efficacy of intraoperative neurophysiological monitoring (IONM) on post operative outcomes preventing neurological injury, predicting post operative neurological deficit and its effect on intraoperative surgeon’s decision making, and to know if it is beneficial or not in intramedullary spinal cord tumors surgeries in adults.

Subjects and Methods

This was observational studies and non randomized controlled studies. our patients were followed up according to this schedule (immediate post operative, first day, three days, first month, three months, six months, one year post operative) and the assessment were done by using Oxford grading system.

Result

Regarding neurological status by clinical examination at last follow up, Improved in 72, transient worsening in no cases, no change in 12 cases and progression in 17 cases, Conclusion.

Conclusion

our systematic review of the literature indicates that there is strong evidence that multimodality neuromonitoring is sensitive and specific for detecting intraoperative neurologic injury during spine surgery. Although the level of evidence supporting the conclusion that intraoperative neuromonitoring reduces the rate of new or worsening neurologic deficits is low, the available evidence does consistently support this conclusion.
Management of Chronic Sacroiliac Joint Pain; Conservative versus Minimally Invasive Intervention versus Sacroiliac Joint Fusion; A Systematic Review
Authors: Mohamed Ismail Mohamed Awad , Ali Nosseir Mohamed ElSayed , Abouelela Abdelmawla Radwan Hesham Mohamed , Abdelrahman Mohamed Abdelrahman Mahmoud
Published: November 2024

Background

Chronic sacroiliac joint (SIJ) pain poses a significant clinical challenge, and the choice between conservative management and minimally invasive interventions or SIJ fusion is an ongoing debate. This systematic review and meta- analysis aimed to compare the effectiveness and safety of SIJ fusion versus conservative treatment versus minimally invasive interventions in patients with SIJ pain of degenerative origin or following lumbar fusion.

Methods

A comprehensive search of PubMed, Web of Science, and Scopus databases was conducted using a predefined search strategy. The search process adhered to the PRISMA guidelines and utilized Cochrane's systematic review methods. Eligible studies were identified through a two-step screening process, and data were extracted for analysis, including visual analog scale (VAS) scores, Oswestry Disability Index (ODI), Short Form-36 (SF-36) scores, and recurrence rates of low back pain. Risk of bias was assessed using Cochrane's risk of bias tool for randomized clinical trials and the ROBINS-1 tool for non-randomized clinical trials.

Results

Sixteen studies met the inclusion criteria, and a detailed analysis of subgroups and overall outcomes was conducted. The results showed that VAS scores at baseline favored the conservative treatment, while VAS score improvements at 3 months were more prominent in the fusion procedure. At 9 months or more, both minimal intervention and fusion procedures demonstrated significant improvements. Regarding ODI, fusion procedures were associated with higher baseline scores, but significant improvements were observed at various time points. In contrast, the conservative treatment showed significant ODI improvements at 3 months. The SF-36 scores varied, with minimal intervention appearing more favorable for SF-36 PCS and MCS after 12 months.

Conclusion

The choice between SIJ fusion and conservative treatment should be tailored to the specific outcome of interest. Fusion procedures, especially for VAS scores and ODI at various time points, offer benefits, while conservative treatment is effective for early ODI improvements. For long-term functional and pain outcomes, both minimal intervention and fusion procedures demonstrate efficacy, with a slight advantage for the fusion procedure. Ultimately, treatment decisions should consider individual patient needs and desired outcomes. Further research is needed to refine treatment recommendations and enhance patient outcomes.
Long Term Effect of Gamma Knife Radiosurgery versus Surgical Excision on Pituitary Hormones in Patients with Non-Compressive Non-Functioning Pituitary Macro Adenomas: A Systematic Review
Authors: Samir Mohammed Wael , Elsayed Ahmed Mohammed , Abdel-Latif Assem Mounir M , Abd Elmonem Elngar Mahmoud Mohammed
Published: November 2024

Background

Pituitary adenomas (PAs) are the second most common brain tumors comprise around 10%– 25% of all intracranial tumors of all primary brain tumors. Their clinical classification is defined on the basis of hormonal level into; Non-Functioning adenomas (68.8%) and Functioning ones (31.2%).

Aim of the Work

Aim of the work is to compare the surgical approach vs gamma knife radiosurgery for treatment of non-functioning pituitary macro adenomas in all age groups. We highlight the feasibility of each treatment modality and evaluate its advantages and limitations regarding hormonal outcomes.

Patients and Methods

We searched PubMed, Google scholar search engine, Cochrane database of systematic reviews, EMBASE and science Direct, using the following keywords “Pituitary adenoma/tumor, endoscopy or endoscopic, non-functioning pituitary adenoma, skull base surgery, gamma knife, stereotactic radiosurgery, hormonal effect ”. The mentioned databases were searched for studies published during period from 1 January 2000 to 1 September 2023.

Results

The total number of patients in included studies was 1237 patients. The mean age of patients was 56.55 years (range 54.2 - 59 years). The mean follow up duration of the included studies was 10.94 months (range 6 - 12.7) months. The mean tumor size was 29.03 mm (range 24.8 - 36.3) mm. All the surgical studies patients were treated using endoscopic trans sphenoidal approach. Basic study details and patient characteristics treated with Gamma Knife Radiosurgery (GKR). Again, all the included studies were retrospective in nature. The total number of patients treated in the GKR studies were 243 patients. Across all studies, 51.85% of patients were men, and the median age was 59.75 years (range: 50–69)

Conclusion

Endoscopic trans sphenoidal surgery and gamma knife radiosurgery are valid options as a treatment of non-functioning pituitary macro adenoma, however endoscopic transsphenoidal surgery offer better hormonal outcomes and less adverse effects when compared to gamma knife radiosurgery.
Comparison between Different Temporary Measures for Management of Post- Hemorrhagic Hydrocephalus in Premature Infants: A Systematic Review
Authors: Hammad Omar Youssef , Nosseir Mohamed Elsayed Ali , Abdelnaiem Ismaiel Ibrahim Abdelmohsen , Ghaly Saif Michael Adel
Published: November 2024

Background

Germinal matrix hemorrhage and subsequent posthemorrhagic hydrocephalus are common among pre-term infants due to multiple factors including fragility of germinal matrix vasculature, swinging increases of arterial and venous pressure, periodic hypoxia, and high metabolic demand.

Aim of the Work

To compare between Ventricular access device (VAD) and Neuroendoscopic lavage (NEL) as temporary measures for management of posthemorrhagic hydrocephalus in premature infants in terms of incidence of permanent shunt placement, and post operative complications like infection. This will be done through a systematic review of literatures addressing this research question.

Patients and Methods

Our study included 13 observational studies (12 retrospective and 1 prospective) comparing ventricular access device insertion vs neuroendoscopic lavage in management of posthemorrhagic hydrocephalus in pre-term infants regarding the need for VP shunt insertion and post operative complications mainly post operative infection and malfunction of the temporary CSF diversion, most of the cases had germinal matrix hemorrhage G III-IV according to papille classification, the results showed that while the neuroendoscopic lavage group had lower rate of VP shunt insertion, they had higher rate of post operative complications mainly malfunction of CSF diversion (The incidence of post operative infection was similar in both groups).

Results

In this review while comparing the need for VP shunt insertion in both groups was somewhat simple, comparing complications on the other hand was problematic due to the heterogenicity between types of complications and the underlying comorbidities, with different follow up periods and most of the complications is not shared by both groups.

Conclusion

Based on our systematic review and other available data in the literature, the neuroendoscopic lavage may be the preferred intervention for management of posthemorrhagic hydrocephalus in preterm infants regarding the incidence of permanent VP shunt insertion, although it has higher rate of malfunction and no statistical difference in post operative infection compared with the ventricular access device group.
Growth Hormone Pretreatment in Poseidon Type IV Undergoing ICSI Using Minimal Induction Protocol: A Randomized Controlled Trial
Authors: Ibrahim Khaled , Fouad Mustafa , Mohamed ElTaieb Ebtihal , ElSaed Ahmed M
Published: November 2024

The aim of this of this clinical trial is to explore whether growth hormone (GH) pretreatment is beneficial for patients with poor ovarian reserve undertaking invitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment. Poor ovarian reserve patients with anti-Mullerian hormone (AMH) <1.2 ng/mL were recruited and divided into the GH adjuvant group (GH+ group) and the counterpart without GH pretreatment (GH- group). One-to-one case-control matching was performed to adjust essential confounding factors between the GH+ group and GH- group. A total of 132 patients were included in the present study with 66 patients in each group. minimal ovarian stimulation protocols were applied for ART treatment. Patients were recruited according to POSEIDON group 4 (PG4, age ≥35 years). The demographic data, cycle characteristics, and clinical outcomes between the GH+ group and GH- group, as well as in the further stratified analysis of PG4 were compared. GH adjuvant showed no significant effect on the ovarian response and live birth rate in poor ovarian reserve patients. GH adjuvant failed to promote the live birth rate in PG4. In conclusion, GH pretreatment has no significant difference as an adjuvant in POSEIDON poor ovarian reserve patients older than 35.
Diagnostic Correlation between Saline Infused Sono Hysterography and Three-Dimensional Transvaginal Ultrasound in the Assessment of Cesarean Section Scar Defect. A Study of a Diagnostic Test Accuracy
Authors: Ahmed Mortada El Sayed , Kolaib Magdy Hassan , Anwar Rania Gamal , Sherif Israa Bahaa Hassan , Maaty Aliaa Mohamed
Published: November 2024

Background

The evolution of Sono hysterography over the past years has contributed significantly to the assessment of uterine cavity. Saline infused Sono hysterography (SIS) may be recommended as an alternative to Diagnostic Hysteroscopy for the assessment of the uterine cavity and uterine scar in women with previous Cesarean Section. Three-dimensional (3D) ultrasonography that enhances visualization of the lower uterine segment (LUS), myometrial thickness and the size of uterine diverticulum is a more recent tool used to diagnose post- cesarean section uterine diverticulum.

Objective

To compare accuracy of three-dimensional transvaginal ultrasound versus saline infused sonography for assessing the characteristics, frequency of caesarean scar defects in symptomatic patients with a history of cesarean section.

Patients and Methods

This study was conducted with 72 women. patients were recruited from the ultrasound unit underwent both three-dimensional transvaginal ultrasound and saline infused son hysterography. This study, conforming to the declaration of Helsinki, was approved by the ethical committee of Obstetrics and Gynecology department, Ain Shams University, ethical committee number FMASU M D 52 \2021.

Results

3D transvaginal ultrasound and Sono hysterography showed almost good agreement regarding prevalence of niche with kappa (κ) 0.780 with p-value (p < 0.001). Both imaging modalities show statistically significant higher mean value of volume in SIS was 591.67±271.05 comparing to 3D TVUS was 444.36±219.42, with p-value (p = 0.004).

Conclusion

There is a substantial agreement between 3D TVUS and SIS in evaluating various niche characteristics, encompassing depth, length, width, volume, AMT and RMT. The data strongly supports the advantages of 3D TVUS over SIS for assessing Cesarean scar defects, commonly known as “Niche.” These benefits encompass cost-effectiveness, improved time efficiency, enhanced patient tolerability, and heightened patient satisfaction associated with the 3D TVUS procedure.
Intraperitoneal Gas Drain to Reduce Postsurgical Shoulder Tip Pain in Gynecological Laparoscopy
Authors: Mahmoud Mohamed Taha Ismail , Abdel-Hafeez Mohamed Abdel Hameed , Zaki Radwa Mansour Mahamed , Saady Abdelghafour Kholoud Khaled
Published: November 2024

Background

Operative gynecologic laparoscopy has become the preferred method for treating benign gynecologic diseases due to its minimally invasive nature and faster recovery compared to laparotomy. However, post-laparoscopic shoulder pain (PLSP) is a common complaint following laparoscopic surgeries, affecting patients' satisfaction and recovery. Various methods have been proposed to alleviate PLSP, but consensus on their effectiveness remains elusive.

Aim of the Work

This randomized controlled clinical trial aims to investigate the effect of gas drainage by intraperitoneal drain on shoulder pain in women after laparoscopic surgery in comparison to no drain use.

Patients and Methods

A randomized controlled clinical trial involving 120 female patients undergoing laparoscopic surgery was conducted to investigate the effect of intraperitoneal drainage on postoperative shoulder pain. The patients were divided into two groups: the study group (n = 60) with intraperitoneal drain placement, and the control group (n = 60) with routine technique and no drain use. Visual Analog Scale (VAS) scores were used to assess shoulder and abdominal pain at different postoperative time points.

Results

The study demonstrated that intraperitoneal drainage significantly reduced postoperative shoulder pain in the first 12 hours after surgery compared to the control group (p < 0.001 at 3 and 6 hours, p = 0.038 at 12 hours). However, no significant difference in shoulder pain was observed between the two groups at 24 hours post-surgery (p = 0.451). The need for postoperative analgesia was also lower in the drainage group (p < 0.001). These findings align with previous studies suggesting the efficacy of drainage in reducing shoulder pain after laparoscopic surgery.

Conclusion

This study demonstrates the effectiveness of intraperitoneal drainage in reducing post- laparoscopic shoulder pain during the first 24 hours after surgery, consequently reducing the need for postoperative analgesics. These findings support the outcomes of previous investigations, indicating that drain placement may be a valuable strategy to alleviate postoperative shoulder pain in women undergoing gynecologic laparoscopy.
Lactoferrin with Ferrous Gluconate versus Ferrous Gluconate for Treatment of Iron Deficiency Anaemia during Pregnancy
Authors: Hitler Waleed , Saad Amr , El-sabai Khattab Nahla Fathy Abdel-samea
Published: November 2024

Background

Iron deficiency is the most common single-nutrient deficiency worldwide. According to the US Centers for Disease Control and Prevention (CDC) recommendations, the diagnosis of anemia during pregnancy must be based on hemoglobin (Hb) values lower than 11 mg/dl during the first and the third trimester or lower than 10.5 mg/dl during the second trimester. Ferrous gluconate that has to be administered to patients with iron deficiency anemia in large quantities due to the poor bioavailability of inorganic iron. Moreover, oral administration of ferrous gluconate causes many side effects, including gastrointestinal discomfort, nausea, vomiting, diarrhea and constipation. Lactoferrin is a multifunctional iron-binding protein possessing anti-inflammatory and anti-microbial effects.

Aim of the Study

The study aims to compare between lactoferrin with ferrous gluconate versus ferrous gluconate in treatment of iron deficiency anemia during pregnancy.

Patients and Methods

This was a randomized controlled clinical trial that was conducted in Ain Shams University Maternity Hospital (ASUMH) from March 2023 to November 2023 on 40 pregnant women who had iron deficiency anemia during pregnancy recruited from inpatient/outpatient antenatal clinic of ASUMH.

Results

Group B had a significant increase in hemoglobin, hematocrit and serum ferritin level, group A had significantly more nausea than group B (p = 0.013), while there was no significant difference between the groups in terms of constipation or non-compliance (p > 0.05), there is no significant difference between the groups in terms of age or gestational age.

Conclusion

In our study we compared between lactoferrin with ferrous gluconate versus ferrous gluconate in treatment of iron deficiency anemia during pregnancy. Accordingly, we found that Oral lactoferrin with ferrous gluconate is better tolerated with higher increase in mean hemoglobin and lower side effects (nausea) when compared to oral iron therapy alone.