bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound guided injection of platelet enriched plasma versus corticosteroids in patients suffering rotator cuff tendinopathy
Authors: Elzaher E H , Kotb A M , Hassaan E H A 
Published: May 2020

Abstract

Background
Shoulder pain is the third most common musculoskeletal complaint. Rotator cuff tendinopathy is an overuse condition that manifests itself as pain in and around tendon and happens when the body fails to regenerate properly. This painful condition is associated with tendon disorganization and thickening that reduces its physical properties, which causes the tendon to fatigue, further exacerbating the painful condition with ultimate failure. A lot of trials and modalities of treatment are studied to avoid the surgical choice such as physiotherapy, NSAIDs and/or ESWT. Local injection of shoulder joint is widely used and studied but the diversity of results lead us to establish further studies.

Objective
The purpose of my study is to compare between two important modalities in non-surgical treatment of supraspinatus tendinopathy.

Methods
This study was conducted on 40 patients divided into two groups: group 1 received 3 subacromial injections of platelet rich plasma 10 days interval and group 2 received single subacromial injection of corticosteroid, both are ultrasound guided. Clinical examination using Constant Score is used to evaluate the patients before receiving treatment (0), one month (1) and six months (6) after receiving the treatment.

Results
We can conclude the results of the 2 groups as there is high significant improvement of the 2 groups comparing base line start. However Corticosteroids shows earlier improvement than PRP after 1 month follow up, but at the end of follow up (6 ms) PRP shows significant improvements according to Constant-Murley Score. According to group 1 there was no complications reported except a discomfort in shoulder region 24 hrs post injection up to 3 days maximum. While in group 2 there was no complications reported all through the 6 months follow up.

Conclusion
Ultrasound subacromial injection of corticosteroid and PRP achieved significant improvement in pain and function of shoulder joint in RCTs. Corticosteroid achieved better improvements according to Constant-Murley Score in short term follow up (4 weeks) than PRP group, while PRP achieved higher significant improvements than corticosteroid in pain and function of the joint after 6 months follow up as corticosteroid group showed decline in the pain and function results after 6 months follow up.
Systematic Review of Literature on the Efficiency of Using PRP in Arthroscopic Rotator Cuff Repair
Authors: Samy T M , Khater A H , Ahmed A K M 
Published: May 2020

Abstract
Rotator cuff tears are one of the most common shoulder problems and the incidence of this condition is increasing along with an aging population. Despite satisfactory results for rotator cuff repair the quality and speed of healing remain problematic. Several studies have demonstrated that native tendon-bone insertions were not restored after tendon to bone repair. Healing of repaired tendons occurred via fibrous scar tissue formation rather than via the regeneration of a histologically normal insertion, and thus repaired tendons have inferior mechanical properties and are more susceptible to retear. Presumably, this is the most significant reason that account for tendon repair failure. Despite recent biomechanical advances in fixation, rates of retear are still high. Tendons consume little energy, and as a consequence healing is slow after injury. Increasing the speed of healing would allow earlier return to work, sport, and activities of daily living, which would be helpful for both the elite athlete and general public. Platelet rich plasma was first popularized in maxillofacial and plastic surgery, but now is thought to enhance and accelerate the repair and regeneration of a variety of tissues, such as bone, cartilage, tendon, ligament, and muscle. This systematic review reporting the effect of PRP after arthroscopic rotator cuff repair.
Cortical Bone Trajectory Screw Fixation of Lumbar Spine in Adult Patients with Degenerative and Traumatic Spine Disorders
Authors: Elbadrawy A M , Elkhateeb T M S , Hassan E M M A 
Published: May 2020

Abstract

Background
the CBT for placing lumbar pedicle screws is a technique used to improve fixation during instrumented fusion of the lumbar spine. In comparison with traditional trajectory (TT) for pedicle screws, CBT screws (otherwise known as pars screws or cortical screws) have a more medial starting point and are aimed in a medial to lateral, caudal to cranial direction. First reported in 2009 as a method to increase the purchase of lumbar pedicle screws within bone.(1)

Aim of the Work
to perform a systematic review and meta-analysis to determine whether traditional Pedicles Screw Fixation (PS Fx) or Cortical Bone Trajectory Screw Fixation (CBT Fx); has been successful for the treatment and fixation of lumbar spine in adult patients with degenerative and traumatic spine disorders; and to compare the 2 techniques to identify risk factor for unfavorable outcome through the recent researches about that issue.

Methodology
this review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines.

Results
meta-analysis study showed that; Successful fusion rate in fixed and random-effects models were (92.24% respectively); in SP group.Successful fusion rate in fixed and random-effects models were (92.44% respectively); in CBT group.Fixed and random-effects models showed non-significant difference in successful fusion rate; between the 2 groups of studies (p &gt; 0.05).
We calculated safety for each technique through post-operative (failed fusion rate).

Conclusion
Although there were insignificant p-values in the most of the comparative items but the CBT showed lower average of intraoperative blood loss, operation time and higher average of decrease in VAS & increase in ODI, slightly higher fusion rate in comparison with PS. So we recommend, the use of CBT as an acceptable alternative of PS in lumbar spine fixation.
Praziquantel - chitosan nanoformulation against murine Schistosoma mansoni infection
Authors: Tawfeek G M , Abdelbaki M H , Ibrahim A N , Hanafy M A , Fathy M M , Diab M S M 
Published: May 2020

Abstract
The aim of the present work was to design praziquantel (PZQ) loaded chitosan nanoparticles (PZQ-Cs) to improve the oral bioavailability and overcome the drawbacks of conventional PZQ therapy. The synthesized chitosan nanoparticles (CsNPs) were physico-chemically characterized by TEM and dynamic light scattering (DLS) with the calculation of the encapsulation efficiency (EE). PZQ was loaded into CsNPs in three different doses; reduced dose (250 mg/kg), high dose (500 mg/kg) and fully effective dose (1000 mg/ kg). Infected treated groups received either oral PZQ-Cs or oral PZQ alone 42 days post-infection and were sacrificed 2 weeks post-treatment. The current study revealed that PZQ-Cs induced a significant anti-schistosomal effect, compared to the infected non-treated control. However, on comparison with conventional PZQ treatment at the corresponding doses, oral PZQ-Cs showed a lower anti-schistosomal potential as reflected by the total worm burden, tissue ova count and oogram pattern. PZQ-Cs was significantly effective in attenuating the oxidative insult associated with S. mansoni infection, compared to the infected non-treated and PZQ treated groups. Genotoxicity assessment proved the safety of CsNPs, as they did not induce a significant DNA fragmentation in non-infected mice treated with blank CsNPs. The present work highlights CsNPs as safe, effective anti-inflammatory and antioxidant agents that could find a clinical use in the treatment of schistosomiasis induced oxidative stress and hepatic dysfunction. Further studies are recommended, however, to investigate how PZQ-Cs could be further modified to increase its anti-schistosomal potential.
Vector-borne disease problems in rapid urbanization
Authors: Zayed A 
Published: May 2020

Abstract
Habitat change of disease vectors has a great impact on their effectiveness to transmit vector borne diseases (VBD). This may result from man-made or natural factors. Urbanization, though it reflects development, is one crucial factor affecting the competence of existing vectors in certain geographic area, or allow for introducing and/or increasing the vectorial capacity of subsidiary vectors. Developing countries, challenging areas with political constrains and those affected by natural disasters are the most threatened areas in terms of VBD continuous change. Vector control strategies are mainly based on having an up-to-date complete knowledge of the spatial and temporal composition of disease vectors. Flexible control and planning decisions, and evidence-based interventions may help containing changes in VBD status due to the rapid urbanization.
The potential diagnostic value of immunohistochemical expression of trop2 in papillary thyroid carcinoma
Authors: Zaki S S , Farid R M , Abugabal H H , Khalil R M 
Published: May 2020

Abstract

Background
The diagnosis of the papillary thyroid carcinoma depends upon the characteristic histopathological features, however there may be borderline cases with controversial features necessitating the use of immunohistochemical studies.Trophoblastic cell surface antigen 2 (TROP-2) is a promising marker that is used recently in the diagnosis of PTC.

Aim of the Work
To highlight the diagnostic value of TROP-2 marker in PTC in comparison with other benign and borderline thyroid lesions on tissue specimens.

Materials and Methods
This retrospective cohort study included 55 cases of PTC, its histopathological variants, benign and borderline thyroid lesions received at pathology department, Faculty of medicine, Ain Shams university between 2011 and 2016. Immunohistochemical evaluation of TROP-2 was applied on. Membranous staining without cytoplasm in &gt; 5% of cells was considered positive. TROP-2 expression in various thyroid lesions were determined by immunohistochemical staining and results were statistically analyzed.

Results
Among the studied cases, 85.1% of PTC demonstrated TROP-2 staining. Most of the cases revealed diffuse staining. No significant staining difference was reported between studied classic and non classic variants. TROP-2 sensitivity and specificity were 85.1% and 94.4%.

Conclusion
In view of present study we concluded the use of TROP-2 as a novel promising marker in the diagnosis of PTC as its positivity was significantly higher in PTC compared to all other non PTC lesion .
Study of Serum Levels of Cyclophilin A in Patients with Coronary Artery Disease
Authors: Zaki M M , Mohsen M , Shaaban M A , Sedky R M 
Published: May 2020

Abstract

Background
Coronary artery disease is a complex chronic inflammatory disease, characterized by remodeling and narrowing of the coronary arteries supplying oxygen to the heart. It is the leading cause of death worldwide being responsible for approximately onethird of all deaths in individuals older than 35 years. Cyclophilin A (CyPA) is a protein secreted from vascular smooth muscle cells (VSMCs) in response to reactive oxygen species (ROS). It is suggested that CyPA plays an important role in later stages of atherosclerosis and plaque rupture. However, little information had addressed the potential relationship between CyPA and CAD.

Objective
Aim of the present study was to assess the role of CyPA in early diagnosis and prediction of severity in CAD patients.

Subjects and Methods
This study was conducted on eighty- nine (89) adult patients undergoing coronary angiography for suspected CAD. They were selected from the Cardiology Department of Ain Shams University Hospitals. According to the angiography findings, 68 patients had CAD and twenty-one age-and-sex matched subjects had normal coronaries and thus were considered as control group. The patients’ group was further classified according to number of occluded vessels into four subgroups; zero-, one-, two- and three-vessel disease subgroups. Blood samples were collected for determination of HbA1c, serum creatinine, cardiac troponin, as well as assay of CyPA. The latter was carried out using double antibody sandwich ELISA technique.

Results
Our study revealed a significantly higher levels of CyPA among patients with CAD than the control group (p &lt; 0.01). Also a significantly higher CyPA levels were detected in zero-vessel group patients when compared with control group (p &lt; 0.05). In addition, significant difference was revealed in CyPA levels between patients with zero-vessel disease when compared to those with one-vessel disease, two-vessel disease and three-vessel disease, being lower in former group than other groups (p &lt; 0.05, respectively). The diagnostic sensitivity and specificity of CyPA were 91.2% and 61.9% respectively at a cutoff value of 7ng/mL for discrimination between patients and control groups. Moreover, the diagnostic sensitivity and specificity of CyPA were 58.3% and 90.5%, respectively at a cutoff value of 13ng/mL in discrimination between zero-vessel disease and control groups. It was shown that 2 by adding hypertension as a risk factor in patient’s group with CyPA &gt; 7ng/mL, sensitivity and specificity were elevated to 95.6% and 76.2% respectively. By applying the same on the zero vessel disease group with CyPA&gt;7ng/mL, sensitivity and specificity were noticeably enhanced to 91.7 and 95.2, respectively.

Conclusion
Cyclophilin A can be used as an early predictor of CAD and in discrimination between zero-vessel disease and healthy individuals. The association of hypertension as a risk factor together with elevated CyPA levels enhances its diagnostic sensitivity and specificity.
Diagnostic Role of Aldoketoreductase family 1B10 (AKR1B10) in Hepatocellular Carcinoma and Benign Hepatic Lesions
Authors: Farid L M , Abdelrahman M H , Sammour S A , Hegazy N A , Ibrahim E , Abougabal H H 
Published: May 2020

Abstract

Background
Hepatocellular carcinoma is the most common primary liver cancer. It is the second most common cause of cancer deaths. The majority of HCCs arise in chronically diseased livers with cirrhotic background. Several benign lesions might be found in a cirrhotic liver along with hepatocellular carcinoma (HCC), and may exhibit typical or atypical imaging features. Distinction between benign hepatocellular nodular lesions, such as hepatic adenoma, and focal nodular hyperplasia, from HCC is of crucial clinical importance in determining appropriate therapy and assessing the prognosis.AKR1B10 is a promising marker that is recently used in the HCC diagnosis.

Aim of the Work
is to study the immuno-histochemical expression of Aldoketoreductase family 1B10 (AKR1B10) in hepatocellular carcinoma and benign hepatic lesions, to assess its role in the diagnosis of hepatocellular carcinoma and in differentiating it from different benign hepatic lesions.
Materials and Methods Hepatocellular carcinoma (HCC(T)):(109), corresponding non tumor tissue with and without cirrhosis (NT):(80), benign hepatic lesions (Focal Nodular Hyperplasia(FNH):(6) and Hepatic Adenoma(HCA)) (6) and Hepatic Cirrhosis (Cs) without HCC (16).

Results
AKR1B10 was over expressed in 82.6% (90/109) of studied HCC cases, negative expression in studied corresponding non-tumor hepatic tissue (NT) in 92.5% (74/80), complete negativity of AKR1B10 was observed in studied benign hepatic lesions 100% (0/12) and also negative expression in 81.3% (13/16) of included hepatic cirrhosis without HCC.

Conclusion
AKR1B10 is a promising marker in the diagnosis of HCC and distinguishing it from other benign hepatic lesions.
Screening for Primary immunodeficiency in Egyptian children with repeated infections
Authors: Elsayed Z A , Elowaidy R H , Sobh A , Aleitewy N S 
Published: May 2020

Abstract

Introduction
Despite efforts, primary immunodeficiency disorders (PIDs) are still under estimated. Predominantly antibody deficiencies (PADs) account for approximately two-thirds of all PIDs. We sought to screen for immunoglobulin deficiency among Egyptian infants and children presenting with unusually recurrent, severe and/ or persistent infections.

Methods
We conducted a cross sectional study that included 75 children presenting with clinical history and/or features suggestive of immunodeficiency. They were enrolled from Children’s Hospitals of Ain Shams and Mansoura Universities. They were subjected to clinical evaluation and measurement of serum immunoglobulin (Ig) levels: IgA, IgG and IgM (by nephelometry) and IgE (by ELISA).

Results
Patients’ ages ranged between 0.5-14 years (median (IQR): 2(0.83-3) with male to female ratio 2:1. Pneumonia was the most common infection (84%) followed by gastroenteritis (64%). Eleven patients (14.7%) had allergic manifestations and three (4%) had suppurative lung disease. Duration of infections per year ranged 3-150 days (median (IQR): 65(60-90), with average of 5 times hospitalization per year. Eighteen (24%) patients had failure to thrive and 21 patients (28%) had absent BCG scar. According to immunological evaluation, 7 patients (9.3%) had combined immunodeficiency, 4 (5%) had agammaglobulinemia, 2 (2.5%) had hypogammaglobulinemia, 2 (2.5%) had Hyper-immunoglobulin E syndrome and one had HIV infection. Patients without B cell defects had significantly higher frequency infection and hospitalization per year compared to those with B cell defects (p = 0.017 and 0.019 respectively). Conclusion: Primary immunodeficiency disorders are not rare. The awareness of families and primary health care physicians is crucial in the establishment of early diagnosis and initiation of appropriate therapy.
Assessment of Hemodynamic Status and Perfusion Markers in Critically Ill Children with Septic Shock
Authors: Abdelgawad T , Mansour M G , Elguindy W M , Khallaf M K 
Published: May 2020

Abstract

Background
Severe sepsis causes release of inflammatory mediators and an associated redistribution of intravascular volume together with depression of myocardial function which manifests as hemodynamic pattern of low cardiac output, low systemic vascular resistance, hypotension, hyperlactatemia and signs of altered tissue perfusion such as oliguria and prolonged capillary refill time.

Aim of the Work
To assess hemodynamic status together with the perfusion markers (lactate) in critically ill children with septic shock.

Patients and Methods
This single cohort study was conducted on 40 patients recruited from the pediatric intensive care units (PICU) at: Ain Shams university hospital, Al-Galaa Military medical complex and Ghamra Military hospital From December 2017 to August 2018.

Results
Only four cases of cases with septic shock developed ejection fraction below 55% denoting myocardial dysfunction during the duration of assessment (first 24 hours of diagnosis). There was negative correlation between cardiac functions represented by hemodynamic measures on one side and SOFA score, PIM 2 score and serum lactate levels on the other side. However, by studying the performance of the parameters included in our study in predicting death; only lactate-24 ≥2.0 (mmoL/L) had statistically significant moderate diagnostic performance, other studied measurements had weak diagnostic performance.

Conclusion
Myocardial dysfunction was found to be common in children having septic shock. Close monitoring and hemodynamic assessment is important to avoid missing these cases. In addition, serum blood lactate level is an important biomarker that should be carefully monitored as it is a good prognostic tool that can predict outcome in pediatric sepsis and septic shock.
Glucose metabolism in liver disease in children Retrospective study
Authors: Elkabbany Z A , Abdelaziz A W , Abdelmageed R I , Fahim M A 
Published: May 2020

Abstract

Background
Diabetes developed as a complication of cirrhosis is known as hepatogenous diabetes (HD). Around 30% to 60% of cirrhotic patients suffer from this metabolic disorder. Insulin resistance in muscular, hepatic and adipose tissues as well as hyperinsulinemia, seem to be pathophysiologic bases for HD.

Objectives
to determine the frequency of diabetes mellitus and impaired glucose tolerance in cirrhotic patients in Ain Shams university hospital of pediatrics and identify risk factors.

Patients and methods
The study included 50 patients, their age is ranging from 6 months to 17 years with chronic liver disease following in the hepatology outpatient clinic (Ain Shams University). These patients were compared according to their fasting plasma glucose, fasting C-peptide, fasting plasma insulin and glycosylated hemoglobin.

Results
28% of the patients included in the study were diagnosed as Wilson’s Disease and 24% were diagnosed as extrahepatic biliary system atresia. Thirty patients (60%) showed impaired glucose tolerance, these patients showed hepatomegaly clinically and by ultrasound, also their liver biopsy showed periportal fibrosis and mild to moderate degree of chronic hepatic fibrosis, decreased level of Hemogolbin, high level of liver enzymes especially alanine aminotranferase, and finally high level of Hemoglobin A1C (glycosylated hemoglobin), fasting plasma insulin and fasting C-peptide.

Conclusion
Most patients with chronic liver disease complicated with liver cirrhosis are liable to develop impaired glucose tolerance and on the long run, they may develop hepatogenous diabetes.
Frequency and Etiology of Nosebleeds among Children in Pediatric Out-Patient Clinic of Ain Shams University Hospitals
Authors: Elalfy M S , Tantawy A A , Badreldin B M , Ebeid F S E , Mekawy M A , Mohammad Y A 
Published: May 2020

Abstract

Aims
Measure frequency, severity, and etiology of epistaxis in a tertiary center pediatric out-patient clinic.

Population
Pediatric patients presented with epistaxis of an unknown cause.

Methods
Thorough clinical assessment, ENT examination CBC and coagulation profile and confirmatory tests when needed.

Results
100 patients with epistaxis (53 females and 47 males) were recruited out of 30043 visits to pediatric OPC throughout one year (1 in 300). Most of them were younger than 12 and nearly half of them were younger than 6 years. 43 patients had epistaxis only, most probably local bleeding (37 had idiopathic epistaxis, 6 had local ENT cause). 57 had other bleeding manifestations, most probably systemic bleeding (47 had a definite bleeding disorder and 10 had undiagnosed bleeding tendency). There was a statistically significant higher number of patients with a positive family history for epistaxis and being referred from a primary care physician in those with probably systemic cause.

Conclusion
Epistaxis is not uncommon, it is not always idiopathic and can be the presenting symptom for an underlying bleeding tendency.