bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of sellar and suprasellar lesions
Authors: Elbakeei H A , Ali A K , Ebrahim K S , Noseir M E , Elsebeely O E 
Published: May 2020

Abstract

Background
Pathology in the sellar and suprasellar regions accounts for several disabling and distinctive neurological syndromes characterized by visual failure and upper cranial neuropathies. These features have a major impact on functional outcome more than the commonly associated endocrine morbidity.

Objective
this study aimed to present the incidence of various lesions in the sellar and suprasellar area and evaluate the different protocols for management of these lesions.

Methods
The study will include 40 cases of sellar& suprasellar lesions that will be admitted and treated in the neurosurgical departments in Ain Shams University Hospital as well as El-Galaa armed forces hospitals and 57375 Children Cancer Hospital between 12/2015-9/2018
Results: Pituitary adenoma was the most frequent(42.5%), followed by craniopharyngioma(30%), then Meningioma(12.5%) with other low frequent diagnoses , Headache was the most common complaint followed by blurring of vision, diplopia and nausea & vomiting. MRI sella was the most valuable investigation. 3 approaches were used and trans-sphenoidal approach was the most common used approach. Postoperative radiotherapy was significantly most frequent in Craniopharyngioma followed by pituitary adenoma and least frequent in meningioma.

Conclusion
we have reached to conclusion from this study, that transsphenoidal approach was suitable for most pituitary adenomas and Its main indication was mainly midline sellar and suprasellar tumors with limited lateral or posterior extension. The pterional approach was suitable for meningiomas and craniopharyngiomas and Its indication was a supra-or parasellar lesions with both lateral and posterior extension specially those reaching the clivus. Total excision was most frequent in pituitary adenoma followed by meningioma and least frequent in craniopharyngioma. Postoperative radiotherapy was significantly most frequent in Craniopharyngioma followed by Pituitary Adenoma and least frequent in meningioma.
Posterior Fossa Mid-Line Space Occupying Lesions Diagnosis and Surgical Outcome
Authors: Abd-allah A N M , Hammad O Y , Elshehaby A M N , Morad S H , Abdelkareem E M 
Published: May 2020

Abstract

Background
posterior fossa tumors are more common in children that in adults. Between 54% and 70% of all childhood brain tumors originate in the posterior fossa. About 15-20% of brain tumors in adults occur in the posterior fossa. Certain types of poeterior fossa tumors, such as medulloblastoma, pineoblastoma, ependymomas, primitive neuroectodermal tumors, and astrocytomas of the cerebellum and brain stem, occur more frequently in children.

Aim of the Work
the aim of this study was to review the preoperative diagnostic modalities, surgical procedures and outcome for different midline posterior fossa space occupying lesions.

Patients and Methods
this is retrospective study has been conducted on 50 patients with posterior fossa midline space occupying lesions during the period March 2013 to October 2015, at Department of Neurosurgery, Ain Shams University. All Patients have been subjected to preoperative clinical assessment; thorough history taking, complete general and neurological examination according to Ain Shams University neurosurgical sheet.

Results
this study was conducted on 50 patients with midline posterior fossa space occupying lesions. All of them underwent a midline suboccipital approach. The pre and post-operative data were collected and analyzed. This study included 50 patient, 26 female (52%) and 24 male (48%) patients. The mean age ranges from 1 year to 60 years.

Conclusion
surgery is the treatment of choice for the cases of posterior fossa mid line lesions especially in children and adolescents to decreases the risk of disabilities and increases the survival.
Impact of Intracranial Pressure Monitoring on Mortality in Patients with Severe Traumatic Brain Injury
Authors: Ali A K , Abdelbar A E , Farghaly A R , Uthman M K A 
Published: May 2020

Abstract

Background
Traumatic brain injury (TBI) is among the most important public health problems associated with high healthcare and social burden and significant mortality and morbidity. Overall low income countries have the highest TBI associated mortality and morbidity.

Aim of the Work
Some studies have demonstrated that intracranial pressure (ICP) monitoring reduces the mortality of traumatic brain injury (TBI). But other studies have shown that ICP monitoring is associated with increased mortality.

Patients and Methods
Systematic review of Published English literature from 2000 to 2017. Using appropriate combinations of MeSH terms and key words, including intracranial pressure, intracranial hypertension, ICP monitor, intracranial pressure monitoring, TBI traumatic brain injury, and craniocerebral trauma. Brain Trauma Foundation guidelines, mortality. We performed this relatively wide search to include the maximum number of relevant patients.

Results
In total, 2552 studies were identified and screened for retrieval using the strategy described above. After careening the title and abstract, 1968 studies were excluded and 554 were retrieved and subjected to detailed evaluations. Based on the inclusion and exclusion criteria, 527 of those studies were excluded, and thus 27 studies were included in the systematic review. All included studies were published, peer-previewed papers.

Conclusion
ICP monitoring may play a role in decreasing the rate of electrolyte disturbances, rate of renal failure, and increasing favorable functional outcome. However, there was no significant effect for reducing the risk of hospital mortality, lowering occurrence rate of pulmonary infection, use of mechanical ventilation and duration of hospital stays. RCTs with larger sample size are necessary to further support the current results.
Oral Paracetamol versus Oral Paracetamol with Codeine as Intrapartum Analgesic in the First Stage of Labor: Randomized Controlled Trial
Authors: Hashad A M , Elbohoty A E , Ahmed M E , Ibrahim K M 
Published: May 2020

Abstract

Background
Labor pain includes components that differ completely from pain in general. It is the result of natural events and has a special meaning, leading in most cases to something extremely positive, the birth of a healthy child. Labor is a painful condition, considered to be one of the most intense and stressful experiences especially for nulliparous women. Although studies have found significant rise in pain threshold during labor. It is nonetheless an important goal to provide safe and effective methods of analgesia for women in a pain in order, amongst other reasons, to obtain her maximum cooperation.

Aim of the Work
The aim of this study is to evaluate the efficacy and adverse effects of oral paracetamol (500mg) during the active phase of labor compared with oral solpadeine (paracetamol 500mg with codeine 8mg) as a method for intrapartum analgesia.

Patients and Methods
This study double blinded randomized controlled trial was conducted on 220 low-risk gravid women have labor pain in first stage of labor and need analgesia comparing the effect of administration of oral paracetamol (500mg) and oral paracetamol 500mg with codeine (8mg) (solpadeine capsule) on managing of pain during active phase of labor. Study setting: The current study was conducted at Ain Shams University Maternity Hospital for about 6 months from February to August 2017.

Results
As recorded by the VAS score, there was significant pain reduction at 1, 2, 3 and 4 hours in both groups (P = 0.001). The reduction in pain was significantly greater in the solpadeine group only at hour 2 (P = 0.001). Maternal complication as nausea, vomiting, abdominal pain and indigestion were 2 fold to 4 fold more in solpadeine group than in paracetamol group.

Conclusion
The use of oral paracetamol as analgesia during labor appeared to be effective, safe, done anywhere of labor situations, with no fetal or maternal adverse effects. Using paracetamol as labor analgesia is a new line; it needs to have more chance in comparison with other forms and routs. Also it can be used as adjuvant drug with other types of analgesics.

Recommendations
Paracetamol may be a good alternative to codeine and opioids as regards analgesic in labor. Maternal and neonatal adverse effects of codeine and opioids as pethidine are good reasons to find another alternative, further randomized controlled trial on wider scale are needed and other forms of paracetamol as suppositories or intravenous are desired to be used as analgesia in different stages of labor and postpartum.
A Comparative Study between Lactoferrin versus ferrous sulfate in iron-deficiency during pregnancy
Authors: Borg T F , Labib K M , Darwish G M 
Published: May 2020

Abstract

Background
Iron deficiency anemia (IDA) is the condition in which there is decrease in the number of red blood cells or the amount of hemoglobin in the blood. It is caused by insufficient dietary intake and absorption of iron, or iron loss from bleeding. Bleeding can be from a range of sources such as the intestinal, uterine or urinary tract.

Aim of the Work
to compare the efficacy and the safety of lactoferrin versus ferrous sulphate for the treatment of iron deficiency pregnant women.

Patients and Methods
This randomized clinical trial was conducted on 98 women selected from pregnant women attending the antenatal outpatient clinic of Ain Shams University Maternity hospital. All patients were divided into two groups; the first group included 49 pregnant women who received lactoferrin (Pravotin100 mg sachets, Hygint pharmaceuticals, Egypt) twice daily orally for 30 days which was dissolved in 1/4 glass of water before meals by 15 minutes. The second group included 49 pregnant women who received 520 mg of dried ferrous sulphate tablets (Feosol tablets, Meda pharmaceuticals, Egypt) once daily orally for 30 days on empty stomach but may be taken with meals to avoid stomach upset.

Results
Total increase in HB after 1month with lactoferrin was higher compared to ferrous sulfate (-13.572 gdl)(p &lt; 0.001). Gastroinestinal adverse events occurred more frequently with ferrous sulfate than the lactoferrin group (p &lt; 0.001).The number of women requesting change the drug was higher in the ferrous sulfate group(p &lt; 0.001).

Conclusion
Oral lactoferrin was better tolerated and more acceptable with higher increase in mean hemoglobin when compared to oral iron therapy over one month treatment. Oral lactoferrin can be used as a good substitute to oral iron therapy in iron deficiency during pregnancy.
Mode of Delivery in Gestational Diabetes Controlled by Metformin versus Insulin: Randomized Controlled Trial
Authors: Sammor H M , Sabaa H A , Abbas A M , Abouelwafa S H 
Published: May 2020

Abstract

Background
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is characterized by insulin resistance or decreased glucose tolerance, which increases throughout pregnancy

Objective
To compare mode of delivery in women with gestational diabetes, treated by insulin versus metformin.

Patients and Methods
The current study was conducted in Ain Shams University Maternity Hospital in the period between August 2016 and August 2018. A total of 124 women were included in the study.

Results
Our study compared mode of delivery in women with gestational diabetes, treated by metformin versus insulin. Our study found that the incidence of cesarean section was statistically significantly higher in the insulin group compared to the metformin group. Fasting glucose levels were statistically significantly lower in the metformin group compared to the insulin group, albeit with minor clinical relevance. No statistically significant differences in postprandial glucose levels or glycosylated hemoglobin were found between the two groups.
Correlation between Serum Levels of Progesterone on HCG Administration Day and Clinical Pregnancy Rate in ICSI cycles
Authors: Raafat T A , Mohammad H F , Hassan E I 
Published: May 2020

Abstract

Background
Infertility is an illness clinically defined as failure to achieve a clinical conception after 12 months of regular and unprotected normal sexual intercourse. It affects around 8 -12% of child bearing-aged couples globally. Premature progesterone elevation is considered for a long time a cornerstone factor to endometrial implantation failure. Although the extensive usage of GnRH analogues for down-regulation of pituitary, rise in progesterone serum levels, still occur at various levels on the day of administration of hCG for ultimate oocyte maturity in fresh IVF management cycles. Aim to investigate and evaluate the correlation between serum progesterone level on the day of HCG administration and the clinical pregnancy rate as a primary outcome, quality of embryo, quality of oocyte, fertilization rate and chemical pregnancy assessed by B-HCG level 2 weeks after embryo transfer as secondary outcomes.

Methodology
This prospective non interventional study was conducted at Assisted Reproduction Unit, Ain Shams University Maternity Hospital, Cairo, Egypt, starting from December 2015 till March 2017. The study included 240 women scheduled for ICSI presented with primary or secondary infertility, the causes of infertility in this study were male factor, tubal factor and unexplained infertility.

Results
the current research study displayed that there was unfavorable statistical correlation between serum progesterone elevation at the day of HCG trigger and the clinical pregnancy rates which was 34.2%, the cut off value of serum progesterone was 1.09 ng/ml; above this value the serum pregnancy rates were negatively influenced. Additionally premature rise of serum progesterone levels reduced the embryonic quality, oocyte quality and fertilization rate.

Conclusion
serum progesterone level equal to or above 1.09 ng/ml at the day of HCG trigger unfavorably influences on the clinical pregnancy rates in ICSI cycles.

Recommendations
All embryos should be cryopreserved when serum progesterone on the day of HCG trigger equals to or above 1.09 ng/ml during ICSI cycle to be transferred in subsequent cycle to avoid implantation failure.
Fetal and Maternal Outcome in Preterm Premature Rupture of Membranes (PPROM) at Ain Shams Maternity Hospital: A Retrospective Analysis of Last Five Years Admissions
Authors: Nageeb A H , Fares M A , Islam B A , Salem H M 
Published: May 2020

Abstract

Background
PPROM is defined as spontaneous rupture of the membranes before the onset of labour prior to 37 weeks gestation. It complicates 2-4% of all singletons and 7-20% of twin pregnancies and is associated with over 60% of preterm births.

Aim of the Work
to retrospectively compare the neonatal and maternal outcomes in women with preterm prelabor rupture of the membranes (PPROM) who delivered before versus who delivered after 34 weeks of gestation over a 5-year period (between January 2011 and December 2015).

Patients and Methods
This retrospective case-control study was conducted at Ain Shams University Maternity Hospital. The analysis covered the period between January 2011 and December 2015. The study included all women admitted to Ain Shams University Maternity Hospital during the period between January 2011 and December 2015 with a diagnosis of preterm prelabor rupture of the membranes (PPROM).

Results
The incidence of chorioamnionitis (p-value &lt;0.001) and maternal sepsis (p-value = 0.001) were both significantly higher in those delivering before 34 weeks. The gestational age at ROM was significantly lower and the latent period was significantly shorter in patients delivering before 34 weeks of gestation (p-values &lt;0.001). The Apgar score at 1 and 5 minutes as well as the birth weight were significantly lower in the group delivering before 34 weeks of gestation (p-values &lt;0.001). The incidence of low Apgar score at 1 and 5 minutes (p-value &lt;0.001 and 0.002, respectively), NEC (p-value = 0.006), IVH (p-value &lt;0.001), RDS (p-value = 0.005) and neonatal death (p-value &lt;0.001) were all significantly higher in patients delivering before 34 weeks of gestation.

Conclusion
In women with premature preterm rupture of membrane neonatal and maternal outcomes is better in those who delivered after 34 weeks of gestation when compared to those who delivered before 34 weeks of gestation.
Retrospective Analysis of Treatment Modalities and Survival of Patients with Cervical Cancer in Ain Shams University Maternity Hospital from 2012 to 2017
Authors: Elshalakany A H , Mamdouh A M , Helal M M O 
Published: May 2020

Abstract

Background
cervical carcinoma is considered the second most common cause of gynecological malignancy death following ovarian carcinoma. The incidence of invasive cervical cancer is higher in low-income countries due to lack of screening programs. There are many treatments for cervical carcinoma, namely surgery, chemotherapy and radiotherapy with different morbidity and survival rates (also according to the stage of the disease).

Aim of the Work
The aim of this work is to review the cervical cancer patients in Ain Shams University Maternity Hospital from 2012 to 2017 in the aspects of demographic characteristics, treatment modalities used, survival and morbidity.

Patients and Methods
the data includes patients diagnosed as having cervical cancer from 1-1-2012 to 31-12-2017 in Ain Shams University Maternity Hospital as retrospective analytical study. We collect name, age, parity stages, Histopathology, treatment, morbidity and survival about each woman and analyze this data.

Results
study included 147 women diagnosed as having cervical carcinoma from 2012 to 2017 in Ain Shams University Maternity Hospital. the most frequent residence was greater Cairo (81%). Majority of patients and their husbands were illiterate (91.8%). Two thirds of the studied cases were married (66.7%). Less than two thirds of the studied cases were postmenopausal (64.6%). The mean age of cases included in this study was 52.3 years. SSC was the most frequent pathology (82.3%). the overall survival rate was 61.7% (survival duration 1.2year with IQR (1→ 2.5 year). By the end of our study 81.8 % of the cases survived in stage I, 65.7 % in stage II, 55.6 % in stage III and 33.3 in stage IV. The most frequent treatment modality was primary radiotherapy without surgery 53.2% with 60% survival with median duration 1year (0.8-2 year) .Then primary radiotherapy with surgery 22.5 % (19.8 % with completion surgery and chemotherapy and 2.7% with salvage surgery) with 56.2 % survival with median duration 1.1 year (1-2.5 year) and the least frequent was 1ry surgery (21.6 %) with 80% survival with median duration 1.8 year (1-3.9 year). Recurrence was in less than tenth of cases (9.3%), the most frequent site was extrapelvic (75.0%).

Conclusion
In Ain Shams University Maternity Hospital the cases are usually clinically presented in late stages and usually with complications due to lack of screening. In developing countries like Egypt, brachytherapy may not be available for all patients. Our study proved that completion surgery after whole pelvic radiation can take place with comparable survival rates and morbidity. Our survival rates are comparable with other studies conducted in developed countries and are good with our limited resources but are less than other studies performed in developed countries.
Umbilical and fetal Middle Cerebral artery Doppler in Patients with Pregnancy Induced Hypertension in the Prediction of Adverse Perinatal Outcome
Authors: Habib S M , Eltaieb E M , Darwish M A H 
Published: May 2020

Abstract

Context
Hypertensive disorders complicating pregnancy are common and form one of the deadly triad, along with hemorrhage and infection that contribute greatly to maternal morbidity and mortality. Close antenatal care is considered the corner stone in early diagnosis of the disease and picking up of the severe cases with subsequent early management and intervention. On the other hand aggressive management of severe cases of high risk pregnancy is considered the second line of defense against maternal and preinatal morbidity and mortality.

Objective
The aim of this work is to assess the accuracy of middle cerebral artery and umbilical artery Doppler in predicting perinatal outcome in women with PIH in the third trimester.

Methodology
In this study which included 100 women with pregnancy induced hypertension who admitted to Ain Shams university maternity hospital our aim was to assess the accuracy of middle cerebral artery and umbilical artery Doppler in predicting perinatal outcome in women with PIH in the third trimester including predicting admission to NICU and the duration of treatment, low Apgar score at 5 minutes, Gestational age at delivery, fetal weight at birth and perinatal mortality.

Results
There was a significant association between MCA PI abnormalities and higher rates of NICU admission, 5-minutes Apgar score &lt; 7, Low gestational age at delivery, Low birth weight and perinatal mortality. We found that the MCA PI for prediction of NICU admission was the best with (sensitivity 86.8 %, specificity 55.3 %, PPV 68.7%, NPV 78.8%).This was more predictive than either the UA-PI or the MCA/UA PI ratio. In our study, MCA PI was found to be a good predictor of poor neonatal outcome in patients with pregnancy induced hypertension especially in prediction of perinatal mortality and incidence of NICU admission.

Conclusion
Middle cerebral artery pulsatility index is more sensitive and more sensetive than umblical artery pulsatility index and middle cerebral arery/ umblical artery pulsitility index ratio in prediction of adverse perinatal outcomes. However middle cerebral arery / umblical artery pulsitility index ratio showed more specificity in predection of perinatal outcome in patients with pregnancy induced hypertension.
Evaluation of Serum Human Epididymis Secretory Protein 4 (HE4) in Benign Endometrial Disease and Endometrial Cancer
Authors: Mohamed S S , Abdelhafeez M A , Mohamed H F , Abukra F M 
Published: May 2020

Abstract

Objective
The incidence of endometrial cancer is constantly growing. More aggressive types of endometrial cancer as well as the incidence in younger women are being observed. More than 80% of cases are diagnosed in early stages due to early symptoms like abnormal bleeding. Aim of our study to evaluate the ability of serum HE4 concentration to differentiate between benign endometrial disease and endometrial cancer and ass’s correlation it with prognosis of EC.

Material and methods
Serum HE4 level was measured in 85 patients with abnormal uterine bleeding. Based on histology after curettage the study group was divided into the benign and malignant endometrial pathology groups. Statistical analysis was performed using Mann-Whitney test

Results
The difference of serum HE4 level between benign endometrial pathology and cancer was significant (p = 0.000) and the cut-off for identification of patients with endometrial cancer was 62 pmol/l. There was a significant difference between Stage (I – II) endometrial cancer, and Stage (III – IV) p = 0.01, Patients who needed lymphadenectomy had significantly higher HE4 level than those who had no indications for this procedure (p = 0,001).

Conclusion
HE4 is a useful biomarker in diagnosing endometrial cancer. HE4 is associated with high grade endometrial cancer. It can also serve as an useful preoperative counseling tool to identify patients, who may require pelvic lymphadenectomy.