bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optical Coherence TomographyStudy of peripapillary Nerve Fiber layer ThicknessinThyroid Associated Ophthalmopathy
Authors: Elkady Z I R , Elwan S , Said A M A , Farweez Y A T , Mahdy M M M 
Published: May 2020

Abstract

Background
Thyroid Associated Ophthalmopathy (TAO) or Graves Opthalmopathy (GO) is a very common autoimmune disorder of the thyroid gland which activates the gland function and result in hyperthyroidism. Some patients with graves disease(GD) develop localized manifestations including GO and dermopathy. Dysthyroid optic neuropathy (DON) is impairment of optic nerve function due to GO, the most serious complication of GO which occurs in about 4–8% of patients, it occurs due to ischemia and inflammation of the optic nerve, also compression of the optic nerve due to enlargement of extraocular muscles at the apex of orbit.

Objective
To assess peripapillary retinal nerve fiber layer (pRNFL) thickness in GD and to correlate it with the severity of the disease.

Patients and Methods
This study was conducted on 40 eyes of 21 recently diagnosed GO patients (two patients were single eyed) recruited from Endocrinology clinic and examined at Ophthalmology clinic, Ain Shams University Hospital in the period from March 2018 to September 2018. Complete ophthalmologic examination, proptosis assessment of direction and degree, Visual Field (VF) examination, clinical activity score (CAS), severity score assessment and Optical Coherence Tomography (OCT) were performed to all patients .

Results
In the whole group of patients; the mean average pRNFL was 109.53 um ± 12.33 SD (range: 86 – 140), median MD was -4.53 (range:-0.66 to-18.95) and -8.04 ± -2.15 SD, mean PSD was 5.55 ± 3.8 SD (range: 1.11 to 12.73). Normal average pRNFL thickness (according to normative data base included in the OCT program) was found in 15 eyes (37.5%) and those had abnormal increase in thickness was 12 eyes (30%). Abnormal decrease in thickness was detected in 13 eyes (32.5%).

Conclusion
PRNFL thickness abnormalities were detected in 25 eyes (62%) of recently diagnosed GO patients. This might be associated with localized visual field defects. Regular follow up of intra ocular pressure (IOP), serial VF examinations, are required to decide further management of those patients, as OCT results were correlated with degree of eye protrusion and the severity of the disease (CAS and severity score).
Comparative Study between Femtosecond Laser Assisted in-situ Keratomileusis and Femtosecond Small Incision Lenticule Extraction for Correction of Myopia and Myopic Astigmatism
Authors: Abutaleb A A , Metwally M G , Elraggal T M , Salem O A 
Published: May 2020

Abstract

Purpose
This study aimed at comparing femto-LASIK with small incision lenticule extraction (SMILE) as regards the safety, efficacy, accuracy and post-operative complications with special emphasis on the post-operative dry eye, corneal sensation and corneal biomechanics in cases of myopia and myopic astigmatism.

Patients and Methods
The study was a prospective comparative study that was conducted in a private eye hospital on 60 eyes of 30 patients with myopia or myopic astimgatism. Each patient was fully assessed preoperatively including visual acuity, refraction, tear breakup time, Schirmer test, corneal sensation & Ocular Response Analyzer®. Femto-LASIK was done to 15 patients and SMILE was done to 15 patients. Postoperative visual acuity, refraction, tear breakup time, Schirmer test, corneal sensation at 1 month, 3 months and 6 months and Ocular Response Analyzer® at 6 months were done and data was retrieved and analyzed.

Results
Cylindrical error was higher in SMILE group at all postoperative points. Tear breakup time was better in SMILE group in 1st month, but no significant difference in later follow ups. Corneal sensation was better in SMILE group in 1 month and 3 months, but this difference disappeared at 6 months. Corneal hysteresis & corneal resistance factor were significantly better in SMILE group.

Conclusion
Both techniques are safe and efficient. Femto-LASIK is more efficient in correcting cylindrical error. SMILE is better in early postoperative dry eye, corneal sensation and in corneal biomechanics.
Visual Field Changes in Multiple Sclerosis
Authors: Mansour D E A , Abdelhamid A M E , Fahmy S S M 
Published: May 2020

Abstract

Background
multiple sclerosis (MS) is a demyelinating disease of the central nervous system and the leading cause of disability in young adults. Afferent pregeniculate visual pathways (retina, optic nerves, chiasm, and tracts) are preferential targets of inflammation, demyelination, and axonal degeneration.

Aim of the Work
in our study was to find and correlate visual field findings in multiple sclerosis patients with clinical data.

Patients and Methods
this study included 30 eyes of 17 patients previously diagnosed as multiple sclerosis according to the international panel on diagnosis of MS (McDonald criteria 2001) and its revision by Polman etal 2005. All our cases were from both sexes and of different age group ranging from 18 years old to 51 years old. there were subtypes of MS included in our study which were relapsing remitting (RR), and secondary progressive (SP). All cases were from Ain-shams university hospitals, outpatient clinics.

Results
this study was conducted in Ain-shams university hospitals out-patient clinics, it included 17 patients previously diagnosed as MS. The age in our study was ranging from 18 to 51 years old with mean age of 33.67± 9.37.Our cases were from both sex with prevelance of female patients.

Conclusion
these findings illustrate the role of perimetry in detecting both clinically overt & and clinically occult optic nerve involvement in patients with MS. It quantifies the depth of visual field loss, identifies atypical cases of optic neuritis, aids in counseling patients about prognosis.
The Effect of Multiple Sclerosis on Nerve Fiber Layer of the Retina
Authors: Mohamed A A A , Saad A M , Mohamed T H , Elzanklony Y A 
Published: May 2020

Abstract

Background
Multiple Sclerosis is a chronic idiopathic inflammatory demyelinating disease involving Central Nervous System white matter with relapsing-remitting nature. Optic neuritis is a common initial manifestation. Multiple Sclerosis is characterized by dual pathological process of inflammation and neurodegeneration. It causes prominent retinal neural ganglion cell layer loss in addition to related axonal loss which can be identified by thinning of RNFL seen in OCT.

Patients and Methods
This case control study was carried out at Ain Shams University Hospitals in MS clinic of neurology department and Ophthalmology outpatient clinics. with a total of 100 eyes, from 50 subjects, Group A (10 patients, 20 eyes): normal persons with normal eyes as a Control group and 40 patients (80 eyes) having multiple sclerosis who satisfied the inclusion and exclusion criteria subdivided into 2 groups,(group B) 20 patients having previous attack of Optic Neuritis & (group C) 20 patients not having previous Optic Neuritis. Informed consents were obtained from all subjects and ethics approval were obtained from Ain Shams University Hospitals Ethical Commitee: A complete ophthalmic history and ophthalmological examination were done for each subject. Visual acuity assessment using Auto Refractometer, refraction, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) assessment using Snellen chart and also calculated in Logarithm of Minimum Angle of Resolution (LogMAR).Pupil reaction. Color vision assessment. Anterior segment detailed Slit Lamp examination. Posterior segment examination (ONH examination) using Slit lamp biomicroscopy, Volk +90 Diopter lens. Intraocular tension measured by Goldmann applanation tonometry. OCT to evaluate RNF layer thickness and c/d ratio.

Results
Our study results demonstrated that: VA & BCVA were statistically significant lower in MS group than the control group (P = 0.011, 0.006 respectively). Total, superior, inferior and temporal RNFL thickness were statistically significant lower in MS group than the control group(P = 0.003, 0.004, 0.028, 0.018 respectively), while there was no statistically significant difference between the two studied groups regarding nasal RNFL thickness. Total, all the four quadrants superior, inferior, temporal and nasal RNFL thickness were statistically significant lower in MS group with previous attack of ON compared with the MS group not having previous ON (P = 0.000, 0.000, 0.004, 0.004, 0.024 respectively).

Conclusion
This study also suggests a great role of ocular imaging techniques such as OCT as an effective noninvasive, high-resolution, non contact tool in mapping of subclinical retinal changes (GCIP layer) in MS patients. It may also serve as a diagnostic adjunct for monitoring disease activity and responses to neuroprotective drugs.
Comparison between surgical outcome between levator resection and levator aponeurosis tucking with non absorbable sutures in mild and moderate unilateral congenital ptosis
Authors: Sargious A A S , Ziko O A O , Fawzy S M , Elsamkary M A M 
Published: May 2020

Abstract

Purpose
To compare levator tucking with resection in mild and moderate congenital ptosis:

Methods
Prospective comparative randomized trial involving 20 eyes of 20 patients, simple mild-to-moderate congenital ptosis with good-to-fair amount of levator action were included. Patients were randomized to either levator resection or tucking. Outcome was compared in terms of eyelid height and course of postoperative events. Data collected included margin reﬂex distance (MRD1), symmetry of eyelid height, contour and complications. Surgery was considered successful if the following three criteria were simultaneously met: A postoperative MRD1 of ≥ 2 mm and ≤4.5 mm, inter-eyelid height asymmetry of ≤ 2 mm, and satisfactory eyelid contour.

Results
Mean age was 12.9 years in resection group (range 5–25 years) and 12.20 years in tucking group (range 4-23 years) postoperative follow-up was 3 months comparing post operative levator function between resection and tucking group was statistically significant (P-value 0.025) tucking didnot improve levator function as much as levator resection did. Mean preoperative palpebral fissure height was 7.8 ml in resection group and6.9 ml in tucking group and the mean postoperative palpebral fissure height was 10.0 mm in resection group and 8.9 mm in tucking group.

Conclusion
Both levator resection and levator tucking are safe and efficient in correcting minimal and moderate degree of congenital blepharoptosis, with less recurrence in levator muscle resection
Surgical Versus Nonsurgical Treatment for Acute Achilles Tendon Rupture A Systematic Review/Meta-Analysis
Authors: Elshazly O A , Mohamed A F , Mohamed Y R A 
Published: May 2020

Abstract

Background and Introduction
Tendon Achilles injury affects 31.17 per 100000 per year, it has major impact on quality of life of affected patients, mostly active young patients. Different management options exist ranging from conservative treatment, to operative repair either open or percutaneous repair.no consensus has been reached on which treatment modality is preferred for each patient .in this study we systematically reviewed the literature for available evidence regarding management of tendon Achilles rupture.

Aim of the Study
to compare the two methods for treating Acute Achilles tendon rupture in a systematic review with meta-analysis and evaluate the functional outcomes of each methods. The objective is to perform a systematic review of overlapping meta-analysis regarding surgical versus non-surgical management of Acute Achilles tendon rupture to assist the decision makers in selecting their decision and provide intervention recommendations by the best available evidence.

Methods
This systematic review consisted of 5 studies, including a systematic search of the literature (PubMed, SCOPUS, and The Cochrane Library), selection of studies, extraction of study characteristics, assessment of methodological quality and bias. and extraction of data on clinical outcomes and their comparisons between different surgical groups.

Results
a total of 9 studies were included, 822 patients were extracted from the included studies. Of the 822 patients, 415 (50.4%) had undergone surgical intervention and 407 (49.6%) had received non-surgical treatment. The minimum follow-up duration was 12 months. The left Achilles tendon was relatively more prone to rupture. The interval from injury to treatment was within 2 to 14 days. Five 5 different surgical techniques were used; end to end, modified Kessler, augmented repair, Krackow type and interrupted circumferential stitch. Operative repair was found to significantly decrease rupture rate (risk ratio of 0.36, 95% CI 0.21-0.64; P = 0.0005) with higher risk of wound complications. No statistically significant difference between the two groups in functional outcome scores and range of motion.

Conclusion
We conclude that surgical technique lowers the risk of re-rupture rate but associated with higher complication rate which can be reduced by using the minimally invasive techniques. Multicenter randomized clinical trials are needed to obtain a high-quality level of evidence for the comparison between the different modified surgical techniques and the gap effect on making different decision of managements.
Bone Graft Vs Bone Substitutes in Treatment of Cavitary Benign Bone Tumors (A Systematic Review Study)
Authors: Mostafa M A , Azmy S I , Helmy K S 
Published: May 2020

Abstract

Background and Introduction
Extended curettage is the commonest mode of treatment of cavitary benign bone tumors. If a tumor is very large and threatening to involve the joint, complete excision with joint reconstruction may be necessary. Cure rates of 90–95% have been achieved using curettage as the sole mode of treatment in benign bony lesions. However this treatment is not devoid of controversy and many authors recommend that bone defect after curettage of benign bone tumors should be filled with bone grafts or bone substitutes.

Aim of the Work
To compare clinical and radiological outcomes, when possible after using of synthetic bone substitutes and bone grafts in surgical treatment of cavitary benign bone tumors.

Materials and Methods
This systematic literature review has included 22 studies and consisting of 4 steps which are a systematic search of the literature (PubMed, SCOPUS, Cochrane Library), selection of studies , recording of study characteristics and extraction of data based on clinical outcomes and their comparisons between different surgical groups.

Results
This systematic review has included 1071 patients of which 742 were treated using different types of bone substitutes, while the remaining 329 were treated using bone grafts (allografts or autografts). Comparing between both groups we have found that the difference in the graft incorporation time between both groups was statistically insignificant which was 6.65 months in group A and 7.01 months in group B with P value = 0.355(NS). The difference in the postoperative fracture rate as well was statistically insignificant; 1.9% in group A and 3.9% in group B with P value = 0.294(NS). However, there was a significant difference in the postoperative infection rate between group A (2.1%) and group B (12.8%) with P value = 0.01(S) and in the recurrence rate as well, which was 10% for group A and 4.3% for group B with P value = 0.002(HS).

Conclusion
Synthetic bone graft substitutes have evolved in response to the downsides of autograft and allograft. No level I studies regarding their use in the treatment of bone tumors have been performed. This study indicates that all of the bone substitutes are safe and may be as effective as other bone graft options and with no limitation in their source for filling the large defects. Prospective randomized clinical trials in the treatment of bone tumors comparing bone graft substitutes versus other grafts (autograft and allograft) are necessary to properly delineate the real indications for bone grafting and to demonstrate the graft’s efficacy in this regard.
Management of Complex Distal Femur Fractures: Comparative Study between Ilizarov External Fixation and Double Plating
Authors: Thakeb M F , Gooda A H , Fayyad T A , Elkersh M A , Abourisha E N 
Published: May 2020

Abstract

Background
In this prospective randomized clinical study, we report results of management of type C2 and C3 distal femur fractures by Ilizarov external fixator in comparison with double plating through separate medial and lateral approaches with a mean of 42.8 ± 6.84 weeks follow-up.

Patients and Methods
In this study we managed 30 cases with highly comminuted distal femoral fractures AO classification type C2 or C3. Fifteen cases were surgically managed by Ilizarov technique and the other fifteen cases were surgically managed by double plating technique. We compare between both group as regard clinical, radiological results and rate of complications.

Results
while using Knee society score, the results are the following: In Ilizarov group: 7 cases (46.67%) are excellent, 4 cases (26.67%) are good, 3 cases (20.00%) had fair results while 1 case (6.67%) had poor results. In internal fixation group, 8 cases (53.33%) had excellent results, 3cases (20%) had good results, 2 cases (13.33%) had fair results while 2 cases (13.33%) had poor results.

Conclusion
In fixation of complex distal femur fracture, both Ilizarov and double plating methods had no significant difference in clinical outcome by knee society score and in rate of complications. Ilizarov allow earlier weight bearing and less blood loss while double plating gives better ROM of knee joint and rapid radiological healing.

Level of Evidence
Level I Randomized controlled study.
Imported Malaria confirmed by immuno-assay
Authors: Abdelgawad S S , Abusarea E Y , Shaapan R M , Ghieth M A 
Published: May 2020

Abstract

Background
Malaria is the most clinically critical parasitic infection worldwide with undesirable morbidity and mortality.

Aim of the Study
This study detected the efficacy of rapid diagnostic test for detection of imported malaria among patients with history of fever and/or had travelled to malaria endemic region.

Subjects and Methods
Blood samples were collected through a year from 732 patients attending three medical laboratories at El Wasta city, Beni-Suef, Egypt. Malaria was tested using thin and thick Geimsa stained blood film and rapid diagnostic test (RDTs) for immunological detection of malaria antigen.

Results
Microscopy reveled malaria in 4 samples (0.5%) distributed as follow, P. vivax, P. falciparum, mixed P. falciparum and P. vivax infection (0.5%, 0.25%, 0.25%, respectively). Antigen detection was positive in 7 cases (0.9%) with maximum sensitivity, satisfied specificity (100%, 98.5%, respectively) and substantial Kappa agreement (0.677). All positive samples for malaria by microscopy were confirmed by malaria antigen detection. All positive samples by microscopy and/or immune-assay were traveled to Sudan (71.4%) or Yemen (28.6%).

Conclusion
Sudan is considered a major focus for imported malaria in Egypt, much restriction rules are needed for travellers and immigrants. Antigen detection using RDTs is a satisfied confirmatory test for suspected cases with fever history.
The Role of Pre-B-cell Colony- Enhancing Factor in Egyptian Children with Hemophagocytic Lymphohistiocytosis
Authors: Ibrahim W E , Ebeid F S E , Mohamed R M 
Published: May 2020

Abstract

Background
Hemophagocytic lymphohistiocytosis (HLH) caused by a highly active but ineffective immune response, including impaired or absent function of natural killer cells and cytotoxic T cells, and the release of pro-inflammatory cytokines. Pre-B-cell colony-enhancing factor (PBEF) is an inflammatory cytokine involved in several inflammatory diseases and it has been identified to react with several cytokines involved in HLH.

Objective
we aimed to evaluate the role of PBEF as a diagnostic and prognostic marker in Egyptian children with HLH.

Subjects and Methods
This is a cross-sectional study, recruited fifteen children with HLH from the Pediatric Hematology/Oncology unit. Patients underwent thorough clinical assessment lying stress on disease manifestation, classification, treatment and prognosis. Plasma concentration of PBEF was determined using an enzyme-linked immunosorbent assay.

Results
PBEF was significantly increase in patients group than control group. Four patients were classified as primary HLH, seven patients were as secondary HLH and four patients had unknown classification due to waiting for genotyping. Seven patients of the study group were died and eight patients still alive. PBEF level showed a significant positive correlation with serum ferritin and triglycerides level and negative correlation with fibrinogen level.

Conclusion
The elevated PBEF level and its correlation with the widely available biochemical markers for diagnosis of pediatric HLH indicating that it may be involved in its inflammatory process.
Screening of vitamin B12 in children diagnosed as Autism Spectrum Disorder
Authors: Metyas M M , Abdelhakim A S , Ghandour H H 
Published: May 2020

Abstract

Background
Vitamin B12 deficiency causes megaloblastic anemia and disorders of the nervous system. In Autism spectrum disorder intestinal problems in absorption of some minerals like Vitamin B12 which lead to Vitamin B12 deficiency.

Aim of the Work
to investigate level of vitamin B12 in autistic children in an attempt to reach such etiological factor and to be incorporated in management if proved.

Patients and Methods
a Case control study. The subjects of this study comprised a convenient sample of 15 children diagnosed as ASD and other 15 children not diagnosed as ASD as control group with age range between 3 years 8 months. Modified Arabic preschool language scale (PLS-4) Test, Stanford Binet intelligence scales, fifth edition were done for all children and Child autism rating scale (CARS) was done for children of 2 groups.

Results
Vitamin B12 level in ASD is significantly deficiency compared to the Vitamin B12 level of normal subjects.

Conclusion
Vitamin B12 in ASD was found to be decreased in cases group than the controls group also below the total language level of cases group than the controls group.
Assessment of Subtle Myocardial Dysfunction in Asymptomatic Infants of Diabetic Mothers
Authors: Kotby A A , Elguindy W M , Soliman N M S , Aboelmaati S A 
Published: May 2020

Abstract

Background
Cardiovascular abnormalities in infants of diabetic mothers (IDMS) occur in the form of congenital heart diseases (CHD), and hypertrophic cardiomyopathy (HCM).

Aim of the Work
We hypothesized that two dimensional speckle tracking imaging and pulsed wave tissue Doppler imaging (TM) may uncover subtle myocardial dysfunction in asymptomatic IDMs.

Patients and Methods
This study was a cross sectional descriptive study conducted at Ain shams University Children’s Hospital Pediatric cardiology unit during the period from June 2017 till January 2018. Thirty IDMs were recruited. IDMs with CHD and HCM were excluded. We further subdivided them into 2 groups; Infants of gestational diabetic mothers (IGDM) and infants of pregestational diabetic mothers (IPGDM). They were all examined using TDI and STI echocardiography in the first week of life. This group was compared to a group of age and sex matched healthy controls.

Results
All IDMs had normal cardiac dimensions and global cardiac functions as controls, IVS (P = 0.434), LVED (P = 0.318), EF (P = 0.291), LVFS(P = 0.644) and GLS(P = 0.240). However, evidence of LV dysfunction proved by increased Tei index (p = 0.018). This subtle affection of myocardial function was more prominent in infants of IPGDM when compared to IGDMs (P = 0.004).

Conclusion
Subtle affection of myocardial functions may occur in IDMs even in the absence of morphological cardiac changes. This was detected by TDI. Neither conventional assessment of myocardial functions, nor STI are sensitive tools in detecting these changes. IPGDMs are at risk of more profound affection of myocardial function than infants of IGDMs.