bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Pet/Ct In Follow Up of Post Therapeutic Colorectal Cancer
Authors: Mohamed M S , Nasr M A , Botros S M , Hafez A A 
Published: May 2020

Abstract

Background
Colorectal cancer (CRC) is one of the most common malignancies worldwide and is a major health problem in developed countries with local and distant recurrences develops in 30–50% of patients during follow-up after primary surgery.

Aim of Work
The present study is aiming at emphasizing the role of PET/CT in Follow up of patients with colorectal carcinoma after treatment, as well as detection of local recurrence and distant metastasis.

Methods
The study included 25 patients with past history of colorectal cancer, they underwent PET/CT examination with the following protocol: Patients were fasting for at least 6 hrs before undergoing scanning. A standard dose of 1-1.5 mCi/kg of F-FDG was intravenously injected 45-60 mins before imaging then initially low dose CT was performed for attenuation correction. After that PET emission scanning was performed immediately after the CT. This was followed by diagnostic CT using IV contrast administration and hyperosmolar oral contrast (diluted mannitol solution) to achieve bowel distension. All data acquired a combined PET/CT in-line system.

Results
The study showed that there is significant paired differences between the number of local lesions as well as metastatic deposition detected in the initial and follow up PET/CT.

Conclusion
FDG PET/CT is extremely useful for therapy response assessment due to its capacity to help distinguish between residual metabolically active tumor and areas of necrosis and fibrosis, thus identifying which of these patients have achieved satisfactory functional remission and which one of them needs further treatment.
The Role of Multi-slice CT in Preoperative Assessment of Temporal bone in patients prepared to cochlear implantation
Authors: Abdulrahman L A , Bakry A M O , Elghobashy M S A 
Published: May 2020

Abstract

Background
MDCT plays a critical role in evaluation and management of different causes of hearing loss which require many therapeutic techniques including cochlear implantation. In general, most causes of hearing impairment are best diagnosed using computed tomography scan of the temporal bone using bone algorithm and windowing techniques.

Patients and Methods
The study included a total of 20 patients referred to the Radiodiagnosis department from the E.N.T department in EL-Galaa Military Hospital. CT was done for assessment of the cochlear state prior to the cochlear implantation operation. The CT was used to delineate the different cochlear and middle ear anatomy and to orient and modify the surgical strategy.

Results
Only 18 patients from 20 patients underwent cochlear implantation, the other two cases were diagnosed as Otosclerosis & Bilateral longitudinal fractures. Patients with multiple other congenital anomalies in the external or internal ear had the cochlear implantation in the other ear (To raise the % of success).

Conclusion
MDCT is the technique of choice in preoperative assessment of patient of SNHL.
MRI versus Ultrasonography in detection of suspected placental invasion
Authors: Abdallah R H , Habib L A , Abdallah Y A , Seweed M S , Youssry N M 
Published: May 2020

Abstract

Purpose
of this study is to highlight the role of MRI and U/S in suspected placental invasion.

Methods
40 patients were included in our study. All clinically suspected patients with previous CS or surgical intervention were subjected to US and MRI.

Results
Our study demonstrated that MRI has a significant promising tool factor for detection of placental invasion degree with high sensitivity, specificity and accuracy and superior to ultrasound in detection of degree of invasion.

Conclusion
MRI imaging of the placenta is of high sensitivity the diagnosis of degree of invasion better than US which couldn’t accurately detect the depth of invasion. Another advantage of MRI is that it’s not operator dependent and gives better tissue characterization.
Evaluation of Different Regimens of New Direct Acting Antiviral drugs (DAAs) for treatment of Recurrent Hepatitis C Virus Infection after Liver Transplantation
Authors: Reda M A , Bahaa M M , Montasser I F , Shamkh M A 
Published: May 2020

Abstract

Aim of the work
To compare between different available regimens of DAAs (sofosbuvir/ daclatasvir and sofosbuvir / ledipasvir) regarding the efficacy and safety for treatment of compensated recurrent hepatitis C Virus infection after liver transplantation in Egyptian patients and to study the correlation between sofosbuvir / daclatasvir and sofosbuvir / ledipasvir and post-transplant complications.

Background
Liver transplantation is the only curative treatment for ESLD and HCC. Liver disease resulting from chronic HCV infection is the leading indication for liver transplantation. For patients with detectable HCV-RNA levels at the time of transplantation, postoperative recurrence of HCV infection was “immediate and universal.” Recurrent HCV infection follows an aggressive course and retransplantation frequently is associated with a poor outcome.

Patients and Methods
This prospective study was conducted on recipients, who underwent living donor liver transplantation in Ain Shams Center for Organ Transplantation (ASCOT) at Ain Shams University Specialized Hospital (ASUSH), Cairo, Egypt between June, 2016 and May, 2017. Data of the recipients, who underwent living donor liver transplantation during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria and received antiviral treatment were followed up monthly during their treatment and after finishing treatment for at least 3 months.

Results
Treatment of HCV recurrence in liver transplant recipients with SOF+DCV+RBV or SOF/LDV+RBV seems to confer high rates of SVR. There was no difference between both regimens regarding adverse events. Prolonged treatment of HCV recurrence after LDLT (24 weeks) was significantly associated with a higher SVR (P = 0.035).

Conclusion
Adding RBV to antiviral regimens in the treatment of HCV recurrence in liver transplant recipients doesn’t seem to add to the efficacy of DAAs. Adherence to prolonged course of antiviral treatment (6 months) when treating HCV recurrence post liver transplantation seems to be associated with higher rates of SVR than shorter course (3 months) with no increase in the incidence of adverse events or rejection episodes.
Evaluation of the Role of Early Second Look Cystoscopy after Complete Resection of Non-Muscle Invasive Bladder Tumors
Authors: Taema K A , Shabayek M , Tawfeek A M , Emam A M , Khafaga M M S 
Published: May 2020

Abstract

Background
most of the bladder cancers are non-muscle invasion at the time of diagnosis. Non-Muscle invasive tumors confined to the mucosa and invading the lamina propria are classified as stage Ta and T1, respectively, according to the Tumor, Node, Metastasis (TNM) classification system.

Aim of the Study
to determine the efficacy of early second look cystoscopy after complete resection of non-muscle invasive urinary bladder tumors and its impact on subsequent treatment policy.

Patients and Methods
this is a prospective clinical study that was done at Urology Department, Faculty of Medicine, Ain Shams University and Damanhur Oncology Centre. A total of 40 consecutive patients with newly diagnosed non-muscle invasive bladder cancer will be enrolled in this prospective study for second-look cystoscopy with TURBT in two to six weeks after initial TURBT and follow them up in one year.

Results
Single tumor was found in 22 cases (55%), while multiple tumors were recognized in 18 cases (45%) with average sizes ranging from 12mm to 70mm. Low-grade transitional cell carcinoma (TCC) was found in 26 cases (65%), whereas high-grade TCC was found in 14 cases (35%). Stage PTa tumors was found in 12 cases (30%) while 28 cases (70%) have had tumors of PT1 stage. All cases underwent an early second TURBT after (2-6) weeks which has reviled the following data. The majority of cases (28 cases) representing 70% of whole study population were free with no detection of any tumors either residual or recurrence. Residual tumors were detected in six cases (15%) all of which detected in patient with large primary tumor size exceeding 50mm or patients with multiple tumors. Whole detected residual tumors were found at edges of primary tumors ranging 2-5 mm in size which were completely resected and they were of the same stage and grade as the initial tumor.

Conclusion
Our findings in this study support the notion that second-look cystoscopy with or without TURBT is a prerequisite in patients with superficial bladder cancers except for patients with solitary, small low-grade pTa tumors. It is particularly highly recommended for patients with extensive and multiple tumors at the first TURBT
Semi-rigid Ureteroscopy and Holmium laser stone dusting for Proximal Ureteral Stones Does Adjuvant Tamsulosin Therapy Increase the Chance of Success?
Authors: Malky P H , Emam A M , Shaker H S 
Published: May 2020

Abstract

Background
Alpha blockers decrease peristalsis above and below the stone, which increases the urine bolus and intraureteral pressure above it and lowers intraureteral pressure below it in association with the decrease in basal and micturition pressure, even at the bladder neck; thus, it increases the chance of stone expulsion.We aim to evaluate whether peri-operative tamsulosin in stented ureteroscopic laser lithotripsy for proximal ureteric stones increase the procedure success rate of stone clearance. Since our aim in ureteroscopic treatment of upper ureteric stones is laser dusting rather than stone retrieval, its possible that alpha blockers can improve the access to upper ureter and clearance of fragmented stones.

Objective
To evaluate whether peri-operative tamsulosin in stented ureteroscopic laser lithotripsy for proximal ureteric stones increase the procedure success rate of stone clearance.

Patients and Methods
This prospective, randomized, multicenter study included 60 patients and carried out between March 2018 and December 2018 in Police hospital Nasr City and Ain Shams University Hospitals included adult patients (at least 15 years) with proximal ureteral stones (≥ 5mm) scheduled for URS lithotripsy.

Results
In this study, the overall failure rate was 18.3%. In most cases 8/11(72.7%), failure of the procedure was due to the difficulty experienced in advancing the ureteroscope. We should mention that this technical problem was reported only in 2 (6.7%) patients receiving pre-URS tamsulosin but in 6 (20%) patients of the control group. The mean operative time in this series was significantly shorter operative time in Group 2(51.8min) compared to Group 1(58.8 min).At follow-up 4 weeks after URS, SFR was (86.7% for Group 2 and 66.7% for Group 1).

Conclusion
Adjunctive tamsulosin therapy prior to laser-assisted semi-rigid URS for the management of proximal ureteral stones improves ureteroscopic access, reduces the operative time and improves the SFR with an acceptable complication rate. Further research should be conducted on a larger scale to evaluate the various predictors of the outcome of URS and analyze the results with different pre-URS tamsulosin time periods in order to consolidate the results and to confirm the conclusion.
Effect of High Dose Tranexamic Acid and Etamsylate in Reducing Blood Loss during Trans-Urethral Resection of Prostate, Bladder Tumours and Percutaneous Nephrolithotomy
Authors: Safan A M , Samir M , Saeed A M , Farag A S I 
Published: May 2020

Abstract

Background
Bleeding is one of the most serious events that can occur intra-operative as well as post-operative in TURP, TURBT, PCNL and minimizing blood loss is of vital role in preventing or reducing morbidity and mortality following these procedures.

Aim of the Work
The aim of the present study was to to evaluate the efficacy of high dose tranexamic acid and etamsylate in reducing blood Loss during TURP, PCNL, TURBT and to determine if we can use them as a routine or not.

Patient and Methods
The study, was a prospective randomized control study, would be conducted on 70 patients admitted through the outpatient urology clinic in Ain shams University Hospitals and Nasser institute hospital. The 70 patients were divided into two main groups. Each one was 35 patients, each group is subdivided into 3 subgroups ((a)TURP,(b)PCNL AND (c)TURBT). Group 1 (all did not receive the combination of high dose tranexamic acid and ethamsylate) Group 2 (all received the combination of high dose tranexamic acid 2g per day and ethamsylate2.5g per day).

Results
We found that hemoglobin and hematocrit drop was significantly smaller in cases group and subgroups compared with the control group and subgroups, we also found that blood transfusion is reduced in control group and subgroups than in cases. Also procedure time was highly significant decreased in cases compared with controls. the high dose combination tranexamic acid 2g per day and ethamsylate2.5g per day was found to be safe without side effects especially thromboembolic side effects.

Conclusion
The study showed that High dose tranexamic acid and etamsylate is safe and effective in reducing blood loss during TURP,PCNL and TURBT. but we still cannot use them as a routine in all patients because our study is conducted on patients with selected criteria so further studies are needed.
Comparative Study between Negative Pressure Wound Therapy (NPWT) and Standard Moist Wound Dressing (SMWD) In Management of Diabetic Non- Ischemic Foot Ulcers
Authors: Zekri M G , Sabbour A S , Mahmoud M S , Abdelmohsen A F , Zaki M M 
Published: May 2020

Abstract

Background
Diabetic Foot Ulcer(DFU) is a common complication of diabetis that has shown an increasing trend over previous decades, 15% of patients with diabetes will suffer from DFU. and approximately 20% of hospital admissions among patients with DM are the result of DFU. Standard moist wound dressing (SMWD) is considered the traditional method for management of DFU. Supporting evidence for NPWT in the treatment of diabetic foot wounds include numerous prospective and multi-centered randomized controlled trials.

Aim of the Work
This study aimed to compare wound outcome, limb salvage between NPWT and SMWT in management of diabetic non ischemic foot ulcers.

Patients and Methods
This is a randomized controlled study involving 60 patients with active diabetic foot ulcers. A computer generated randomization pattern will be used to segregate the patients into 2 groups (NPWT and SMWD groups). Primary end point of the study is to achieve full healthy granulating wound (without necrotic tissues, bone or tendon exposure and without local signs of infection). follow up included change in wound diameter, depth, up or down scaling along UTWC, wound status every 2 weeks.

Results
there was a statistically significant difference in rate of depth improvement for the NPWT group in 2 and 4 weeks. In six weeks follow up, the rate of depth reduction was better in NPWT group but it wasn’t statistically significant (p-value 0.14). There was a statistically significant difference in reaching full healthy granulation in 4 and 6 weeks in favor of the NPWT group compared to the SMWD, there was no statistically significant difference in number of cases reaching full healthy granulation in 8 weeks as many cases of SMWD group started to achieve full healthy granulation. Number of bed side debridement or surgical debridement was not statistically significant between the 2 groups. major amputation was seen in 4 cases of the SMWD group, and one trans-metatarsal amputation and 2 toes amputation was seen in NPWT group and none of these was statistically significant.

Conclusion
NPWT use in DFU provides a significant reduction in duration till reaching full healthy granulation. No significant difference was observed in ulcer related complications such as infection, cellulitis, and osteomyelitis. However, the study showed that SMWD patients had more secondary amputations than those receiving NPWT but it wasn’t statistically significant
An evaluation of the effectiveness of teaching anatomy to rheumatologists through combined musculoskeletal sonoanatomy and human cadaveric dissection
Authors: Manghani Mona , Cheung Peter P , Mogali Sreenivasulu Reddy , Prakash Ashutosh , Chew Li-Ching 
Published: May 2020

Abstract

Objective
Our aim was to evaluate the effectiveness of teaching anatomy through combined musculoskeletal sonoanatomy and human cadaveric dissection for rheumatologists practising musculoskeletal US.

Methods
The principal focus was on scanning and then dissecting relevant musculoskeletal structures. Outcomes measured included confidence levels and objective knowledge. A mixed-methods approach of evaluation and descriptive statistical data analysis was performed.

Results
The change in confidence ratings by delegates after the teaching event as represented by the mean difference (s.d.) (s.e.m.) for identification of surface anatomy was 1.846 (1.281) (0.355), with Student’s paired t = 5.196 and P=0.000223. The mean difference (s.d.) (s.e.m) for performing IA injections was 1.538 (1.266) (0.351), with Student’s paired t = 4.382, P=0.001, and for recognizing sonoanatomical structures it was 1.769 (1.235) (0.343), with Student’s paired t  = 5.165 and P= 0.000235. There was a significant increase in correct identification of anatomical and sonoanatomical knowledge in the pre- and post-course assessments. Rotator cuff interval region improved from 13 to 73%, P  = 0.004; knee tendons insertion sites from 47 to 93%, P  = 0.016; and muscles not adjacent to joints from 27 to 93%, P  = 0.002.

Conclusion
Dissection of joints enabled a three-dimensional relational mind map of the relevant regions of the human body, producing clarity in understanding regional relational topographic anatomy and sonoanatomy. The combination of US and cadaveric dissection improved learners’ satisfaction, confidence and knowledge in areas where soft tissue complaints are common, which is likely to lead to accurate early diagnosis and cost-conscious, better overall care.
A clinical and radiographic comparison of patients with psoriatic arthritis from different ethnic backgrounds
Authors: Aslam Tariq , Mahmood Farrouq , Sabanathan Anetha , Waxman Robin , Helliwell Philip S 
Published: May 2020

Abstract

Objectives
There are few papers concerning ethnic differences in disease expression in PsA, which may be influenced by a number of genetic, lifestyle and cultural factors. This article aims to compare clinical and radiographic phenotypes in people of South Asian (SA) and North European (NE) origin with a diagnosis of PsA.

Methods
This was a cross-sectional observational study recruiting patients of SA and NE origin from two hospitals in a well-defined area in the North of England.

Results
A total of 58 SA and 48 NE patients were recruited. SA patients had a more severe clinical phenotype with more tender (median 5 vs 2) and swollen (median 1 vs 0) joints, more severe enthesitis (median 3 vs 1.5), more patients with dactylitis (24% vs 8%), more severe skin disease (median PASI 2.2 vs 1) and worse disease activity as measured by the composite Psoriatic Arthritis Disease Activity Score (mean 4.5 vs 3.6). With regards to patient-completed measures, SA patients had worse impact with poorer quality of life and function (mean HAQ 0.9 vs 0.6; mean PsAQoL 10.8 vs 6.2; mean 36-item short form physical component score 33.5 vs 38.9). No significant differences in current MTX and biologics use were found.

Conclusions
SA patients had a worse clinical phenotype and worse impact of disease than NE patients. Further studies are needed to confirm and explore the reasons behind these differences.
The Impact of Environmental Chemicals on the Gut Microbiome
Authors: Chiu Karen , Warner Genoa , Nowak Romana A , Flaws Jodi A , Mei Wenyan 
Published: May 2020

AbstractSince the surge of microbiome research in the last decade, many studies have provided insight into the causes and consequences of changes in the gut microbiota. Among the multiple factors involved in regulating the microbiome, exogenous factors such as diet and environmental chemicals have been shown to alter the gut microbiome significantly. Although diet substantially contributes to changes in the gut microbiome, environmental chemicals are major contaminants in our food and are often overlooked. Herein, we summarize the current knowledge on major classes of environmental chemicals (bisphenols, phthalates, persistent organic pollutants, heavy metals, and pesticides) and their impact on the gut microbiome, which includes alterations in microbial composition, gene expression, function, and health effects in the host. We then discuss health-related implications of gut microbial changes, which include changes in metabolism, immunity, and neurological function.
A model showing the relative risk of viral aerosol infection from breathing and the benefit of wearing masks in different settings with implications for Covid-19
Authors: Barr Gerald D 
Published: May 2020

AbstractBackgroundWidespread use of masks in the general population is being used in many countries for control of Covid-19. There has been reluctance on the part of the WHO and some governments to recommend this.MethodologyA basic model has been constructed to show the relative risk of aerosol from normal breathing in various situations together with the relative benefit from use of different masks.ResultsThe benefit from mask use between individuals is multiplicative not additive and although social distancing at 2 meters appears beneficial with regards to aerosol infectivity, in confined areas this is time limited requiring additional measures such as masks. The model shows the relative benefit of masks when social distancing is not possible at all times, or when in confined areas which can also be aided by efficient ventilation. Where a person is in one place for a prolonged period there is more risk requiring protection.ConclusionsMasks should be used in the above situations especially at an early stage of an outbreak. Public health planning requires stockpiling of masks and encouraging everyone to have suitable masks in their household when supplies are normalised. In the absence of widely available good quality masks the use of a cloth mask will be better than no protection at all.