bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaginal versus Intramuscular Progesterone for Prevention of Preterm Labour in Women with a Twin Pregnancy: a Randomized Controlled Trial
Authors: Tantawy W H , Ghaleb M M , Elsayed M M A 
Published: May 2020

Abstract

Background
Twins constitute 2-4% of all births, and the rate of twining has increased by 76% between 1980 and 2009.Twin pregnancies, compared with singletons, are at increased risk for fetal anomalies, preterm births, aberrant fetal growth, cerebral palsy, and perinatal and infant mortality. Maternal complications associated with twin pregnancies include hypertensive disorders, gestational diabetes, cesarean delivery, postpartum hemorrhage, and maternal mortality.

Aim of the Work
This study aims to assess the efficacy of vaginal progesterone compared to intramuscular therapy in decreasing the rate of preterm birth in women with twin pregnancy.

Patients and Methods
Randomized Controlled Trial, women presented to Ain Shams University Maternity Hospital. The study was presented for approval from the ethical committee of the department of Obstetrics and Gynecology, faculty of medicine, Ain Shams University. Informed consent after explaining the study purpose and methods to the subjects. Data presentation will not be by the patient name but by diagnosis.

Results
There is no statistically significance between the two groups regarding number of neonatal RDS, NICU admission and neonatal death but lower percentage among vaginal progesterone group. Birth weight was significantly higher among vaginal group. NICU stay was significantly higher among intramuscular group.

Conclusion
Compared with intramuscular 17-OHPC, vaginal progesterone in women with twin pregnancy is associated with lower percentage of preterm labour, less recurrent SPTB, less adverse maternal side effects, fewer NICU admissions, better compliance.
Endometrial Thickness and Subendometrial Vascularity in Anovulatory Polycystic Ovarian Syndrome Patients Treated by Metformin
Authors: Khalaf W M , Akl S A , Ramadan R R , Kamaleldin M A M 
Published: May 2020

Abstract

Background
PCOS, the commonest endocrinalogical disorder affecting women of age group between 18 and 44 years. PCOS compromises fertility through various pathways as hyperandrogenism, insulin resistance and impedance of the uterine and endometrial blood flow. Metformin improves the blood flow to the endometrium through reducing androgen level and correction of insulin resistance. The commonest parameters used to detect the endometrial receptivity outcome are endometrial vascular indices.

Aim of the Work
to evaluate the outcome of metformin administration in anovualtory PCO patients and its effect on the endometrium, including its role in ovulation and improvement of pregnancy rates.

Patients and Methods
this study included 85 patients from Ain Shams University outpatient gynecology and infertility clinic during the period from January 2018 till June 2018. These patients were investigated before treatment with ultrasound on day 14, 21 to evaluate the endometrial receptivity parameters such as endometrial thickness, uterine artery vascularity, endometrial and subendometrial vascularity. The patients received metformin 500mg three times per day for three months. After this duration they were reevaluated by ultrasound at days 14, 21 to detect any improvement.

Results
metformin therapy resulted in a significant increase of endometrial thickness and had a significant effect on uterine RI and PI. On the endometrial level, the endometrial and subendometrial R.I and P.I were significantly reduced after metformin treatment indicating better blood flow.

Conclusion
Metformin therapy improves endometrial vascularity, in addition to increasing endometrial thickness and improved impedance observed in uterine artery flow.
Concurrent Palliative Chemoradiotherapy versus Definitive Chemoradiotherapy in Poor Prognosis Stage III non-small-cell lung cancer
Authors: Elkhafif M A , Elbassiouny M , Elhusseny K , Salem D , Shafik A 
Published: May 2020

Abstract

Background
The palliative role of chemoradiation in treatment of patients with locally advanced non-small-cell lung cancer remains unresolved; Controversy remains about whether long term and high doses radiotherapy provide better results than short course schedules in treatment of inoperable stage III NSCLC and negative prognostic factors poor performance status (PS), large tumor, poor pulmonary functions and comorbidities.Hypofractionated radiotherapy can expose tumors to a high dose of radiation in a short period of time.

Methods
One hundred and ten patients with locally advanced stage III NSCLC with poor prognosyic factors were randomized to receive either definitive chemoradiation or palliative chemoradiation in cancer department of faculty of medicine of AIN SHAMS UNIVERSITY .Arm (A) patients will receive induction chemotherapy with two cycles of carboplatin(AUC6) and paclitaxel 175mg/m²) cycles every 21 day, the third cycle administrated with radiotherapy with low dose of carboplatin(AUC 2) and paclitaxel 60 mg/m² on day 1& 8 administrated concomitant with the radiotherapy 42 Gy over 15 fraction over 3 weeks. Arm (B) patients will receive standard-dose fractionation of radiation 60Gy/6 weeks 2Gy once per day with concurrent weekly low dose of carboplatin (AUC 2) and paclitaxel 60 mg/m² followed by two cycles of full doses of carboplatin (AUC 6) /paclitaxel 175mg/ m² every 21 days.the primary end points were overall survival and progression free survival;secondary end points were health related quality of life(HRQOL) and toxicity.

Results
The median follow-up duration was 24 months in surviving patients’ .Median survival and 2-year OS were in concurrent palliative chemoradiation arm 4.7 and 12.3-months respectively and was 7.3 and 17.6 in concurrent definitive chemoradiatiobn arm respectively (p &lt; 0.01). HRQOL was better in the palliative arm during the treatment but remained unchanged in both arms during the follow up visits. There were more hospital admissions related to side effects in the definitive chemoradiation arm (p &lt; 0.05).

Conclusions
This study confirmed that the definitive chemoradiation was superior to palliative chemoradiation arm with respect to survival.the treatment related toxicity and HRQOL were better in the palliative chemoradiation arm than the definitive arm.
Retrospective Analysis of Clinical Epidemiology in Gastrointestinal Stromal Tumour
Authors: Farag A L , Ezzeldin M M A , Mosalam N A , Mohammed M M A A 
Published: May 2020

Abstract

Background
Gastrointestinal Stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract (GIT) i.e. sarcoma. GIST is classified into mutation in KIT (cluster of differentiation 117, CD117) oncogene (85%), Platelet — derived growth factor receptor alpha gene (PDGFRA) (10%) or rarely B-Raf gene. C.Kit - which is mutated & activated in 80% of GIST- is an oncogene which encodes cell surface receptor Tyrosine Kinase TK (CD 117) which is responsible for activation of multiple signaling cascades leading to cellular proliferation.

Aim of the Work
to explore the best management options of care for patients at Ain Shams University Hospitals (ASUH) by retrospectively analyzing epidemiological factors in Gastrointestinal stromal tumor patients and correlate them to clinical outcome; these factors are either patient or disease ones, while outcome include clinical benefits, survival and encountered toxicities.

Patients and Methods
this is a retrospective study. This study included 34 patients with GIST treated at the department of Clinical Oncology and Nuclear medicine, Ain Shams University between 2011 -2017 and followed up till 1-2017.

Results
many prognostic factors were selected for analysis to evaluate their impact on overall survival. Age, gender, site and size of tumor, mitotic index, histopathology, presence of metastasis at time of presentation and anemia all had no statistically significant impact on overall survival.

Conclusion
the prognosis of GIST is undoubtedly better than other sarcomas. No clear risk factor of GIST. Patient selection is paramount as to minimize the high cost of treatment. Tumor density must be known by Hounsfield unit before treatment to detect pseudo progression. Molecular analysis by PCR is very important to know sensitivity to treatment as a predictive biomarker. Patients should be kept on follow up for early detection of recurrence.
A retrospective study of Epidemiology and prognostic factors of small cell lung cancer
Authors: Elwakeel H , Ellithy M , Hassanien S , Helaly M 
Published: May 2020

Abstract

Background
Lung cancer has been the most common cancer overall for several decades. According to the last data of GLOBOCAN series of the International Agency for Research on Cancer there were estimated 1.8 million new cases in 2012 of which 1.2 million cases estimated to occur in males with lower incidence rate in females about 583,000 cases.

Aim of the work
This study aims to ascertain retrospectively the epidemiology and prognostic factors of small cell lung cancer (SCLC) and also highlights the outcomes in the terms of overall survival (OS) and progression free survival (PFS) among Egyptian patients at clinical oncology and nuclear medicine department, Ain Shams university hospitals
Results The files of 56 patients with SCLC were reviewed. 17 patients were excluded from analysis due to insufficient data in the files. Among the 39 patients in the study, 32 patients received active treatment, while 2 patients received only WCI as palliative intent, 2 patients received best supportive care treatment as they were not fit for treatment (PS: 3-4) and 3 patients didn’t receive treatment as they lost follow up before starting treatment.

Conclusion
SCLC is usually diagnosed in advanced stage and No great improvement in survival over the past years, so, health care centres should monitor the efficacy of their management plans by comparing survival outcomes with other centres. Prognostic factors are essential in better understanding the treatment outcome in terms of OS and PFS.
Retrospective Analysis of Clinicopathologic and Management Aspects of Soft Tissue Sarcoma
Authors: Kamel T H , Adel A M , Faheim R M , Hegazy R 
Published: May 2020

Abstract

Background
Soft tissue sarcomas (STS) are a group of rare aggressive tumors of mesenchymal origin, separated into over 50 different subtypes by histological and molecular classifications, In this analysis we evaluated the clinicopathologic and management aspects of STS. We analyzed the prognostic and predictive factors affecting both OS & PFS.

Patients and Methods
Medical records of 92 patients with STS were reviewed retrospectively. Overall survival (OS) and progression free survival (PFS) were estimated and factors potentially influencing these outcomes were analyzed.

Results
The mean age of patients was 45 +- 15.95 years (range 16-84 years). Median OS was 35.6 +_ 5.2 months and median PFS was 10.2 months. Age was assessed as a predictive factor for OS and patients &lt;50 years had higher median OS (42.3 months) compared to patients &gt;50 years’ old who had median OS (13.2 months) with no statically significance (P = 0.069). Also patients ≤50 years had median PFS (12.1 months’ vs 10.1 months) in patients ≥ 50 years with no statistically significance on PFS type. Type of pathology was also highly significantly correlated to overall survival (P = 0.000), liposarcoma had improved OS (42.3 months) compared to other histopathological subtypes. However, it showed no statistically significance to PFS (P = 0.036) with higher median PFS in liposarcoma (22.3 months) compared to other histopathological subtypes.

Conclusion
Mean age was found to be 45.9 +- 15 years old, with type of pathology. Histopathological subtypes and disease status were assessed as predictive and prognostic factor and were found to be highly correlated to OS. Effect of RTH on OS and PFS is well noted
Evaluation of retinal vasculitis among cases of Behçet disease
Authors: Samaan M E B , Saad A H , Mohammed T H , Elzankalony Y A 
Published: May 2020

Abstract

Background
Behçet disease is an obliterative and necrotizing systemic vasculitis that involves different organ systems. It affects both arteries and veins, mainly the veins. Ocular affection is one of the major criteria of Behçet disease; the most common ocular presentation is bilateral non-granulomatous panuveitis with retinal vasculitis.

Purpose
To identify early, evaluate and follow-up properly the posterior segment involvement in Behçet disease cases with the help of Fundus fluorescein angiography and Optical coherence tomography.

Patients and Methods
This is a descriptive cross sectional study involved 40 eyes. All patients had a complete ophthalmological examination, a comprehensive history taking as well as review of systems and the laboratory tests. This is followed by pupillary dilatation and retinal imaging by fundus fluorescein angiography and optical coherence tomography.

Results
On ophthalmological examination, 35 eyes had retinal affection due to Behçet disease and 5 eyes are retina-free. The most common retinal affection was vasculitis in 29 eyes, followed by optic nerve affection in 10 eyes then less common was retinitis in 6 eyes. Regarding visual acuity (VA) 14 eyes had low visual acuity of less than (6/60), 21 eyes had VA between (6/60 – 6/12) and 5 eyes had good visual acuity of more than (6/12). Fluorescein angiograms showed that, 36 eyes representing 90% of the total eyes had abnormal angiogram; vascular leakage was the commonest abnormality in 29 eyes, less common was optic disc edema in 12 eyes, then retinitis in 6 eyes. Macular edema was present in the angiogram of 6 eyes. About OCT, there were abnormalities in 33 eyes; macular edema was the most common in 21 eyes, epiretinal membrane (ERM) in 9 eyes, then neurosensory detachment (NSD) and macular hole each was seen in 4 eyes.

Conclusion
This study demonstrated that posterior pole involvement, retinal vascular leakage, optic disc hyperfluorescence, and macular leakage are significantly associated with worse VA in Behçet retinal vasculitis. This suggests that, use of Fundus Fluorescein Angiography and Optical Coherence Tomography in evaluation of Behçet retinal vasculitis is clinically significant in predicting visual prognosis and determining of treatment efficacy.
Subfoveal Choroidal Thickness Measured By Swept Source OCT in Retinitis Pigmentosa Patients
Authors: Mahmoud Y M , Eliwa T F , Elmofty H M , Elmaamoun T A 
Published: May 2020

Abstract

Background
Retinitis pigmentosa (RP) encompasses a group of hereditary retinal diseases that result in progressive loss of rod and cone photoreceptors. It occurs in approximately one in 4000 individuals, with a worldwide prevalence of 1.5 million affected individuals.

Aim of the Work
This study aimed measure the subfoveal choroidal thickness and outer retinal layer thickness in patients with Retinitis Pigmentosa and correlate them with visual acuity.

Methods
Fifty eyes of clinically and electrophysiologically confirmed retinitis pigmentosa patients compare to fifty eyes of normal healthy individuals of the same age group as controls.
Both groups were investigated for best corrected visual acuity (BCVA)(LogMAR) and Swept Source optical coherence tomography (SS-OCT) evaluating outer retinal layer thickness (ORL), central foveal thickness and subfoveal thickness (SFCT) and the integrity of inner segment-outer segment junction IS/OS as being (Intact (+) or disrupted (-)),

Results
Mean ages were 34.5 ± 11.3 years for controls versus 38.8 ±12.8 years for RP patients (p &gt; 0.05). Mean BCVA (logMAR) was 0.86 for RP group vesus 0.02 for control group. Mean subfoveal choroidal thickness (SFCT) measurements were significantly lower in RP group (288.4 µm) than control group (333.7µm) (P value = 0.008). Significant difference was found between choroidal thickness and BCVA (logMAR) (p-value &lt;0.001). Presence of IS/OS was significantly correlated with BCVA (log MAR) (p value=0.0001). And finally, there was moderate negative correlation between central foveal thickness and BCVA (logMAR) (r = -0.414, p-value = 0.012).

Conclusion
Submacular choroidal thickness as measured by SS–OCT, is significantly reduced in patients with RP and significantly correlated to BCVA and IS/OS integrity.
Effect of Ranibizumab Treatment in Cases of Choroidal Neovascular Membranes Secondary to Pathological Myopia versus Age-Related Macular Degeneration
Authors: Abdaltawab M S , Ismail Z F , Ebeid W M A , Fawzy S M 
Published: May 2020

Abstract

Aim of the Work
The aim of this work is to compare the response of treatment with ranibizumab in terms of visual acuity in cases of CNV secondary to pathological myopia versus CNV secondary to age-related macular degeneration.

Methods
This prospective, comparative study included ten eyes newly diagnosed as having CNV secondary to pathological myopia, and 10 eyes newly diagnosed as having subfoveal active CNV secondary to AMD. All patients had 3 monthly intravitreal Injections of 0.50 mg (in 0.05 ml of solution) ranibizumab with monthly evaluation of best corrected visual acuity (BCVA) by Landolt C chart, and also calculated in Logarithm of Minimum Angle of Resolution (Log MAR).

Results
pretreatment there was no significant difference between the two groups as the mean VA (Log Mar) was 1.31 ± 0.2 in AMD group and 1.17 ± 0.3 in MCNV group of P value = 0.431 and also post three IVI of ranibizumab showed no significant difference between the two groups as the mean VA (Log Mar) was 1.22 ± 0.2 for AMD and 1.22 ± 0.5 for MCNV of P value = 0.635.

Conclusion
there was no significant difference in BCVA between AMD and MCNV groups after three intravitreal injections of ranibizumab.
Comparison between the Characteristics of Femtosecond laser Anterior Capsulotomy Versus Manual Capsulorhexis and their Effects on Intra Ocular Lens Centration, Effectiveness and Safety in Cataract Surgery
Authors: Ali D A M , Hamza I I , Abdelrahman S H , Abdelaziz T M 
Published: May 2020

Abstract

Background
Cataract is characterized with opacity of the crystalline lens that can markedly limit the routine activities of patients such as reading, writing, walking and in the long run reduce the quality of life. Cataract is the main cause of preventable blindness. Despite some modern advances in the field of cataract impending drug treatments, surgical treatment is still known to be the most actual treatment option(1).

Objective
To perform a meta-analysis on the characteristics of femtosecond laser anterior capsulotomy and manual capsulorhexis and their effects on intra ocular lens (IOL) centration, effectiveness and safety in cataract surgery.

Methods
This meta-analysis was conducted from 1/1/2015 to 31/7/2018. Literature search on PubMed was done to identify randomised controlled trials (RCT) and comparative studies MedCalc ver. 18.2 (MedCalc, Ostend, Belgium) was used for data analysis.

Results
Of the 17 articles included, there were 3 (18%) randomised controlled trials and 14 (82%) comparative study. The meta-analysis was based on a total of 18558 eyes. Of them, 9442 (50.88%) underwent femtosecond laser-assisted cataract surgery (FLACS) and 9116 (49.12%) underwent manual continuous curvilinear capsulorrhexis (CCC). Comparative study between the 2 groups revealed; highly significant increase in better IOL centration; in FLACS group compared to CCC group (p &lt; 0.01), there is non-significant difference as regards capsulotomy diameter (p &gt; 0.05) and non-significant difference as regards corrected distant visual acuity (CDVA) ,un corrected distant visual acuity (UDVA) and mean absolute error (MAE) (p &gt; 0.05).
As regards the complications; fixed-effect model showed highly significant increase in complications rate in FLACS group; but random-effects model showed non-significant difference between the 2 groups (p &lt; 0.001, p &gt; 0.05 respectively).

Conclusion
FLACS is better for IOL centration, but there is non-significant difference between FLACS and manual CCC as regards capsulotomy diameter, CDVA, UDVA, MAE and complication rate.
Correlation of Structural and Functional Changes in Ocular Hypertension and Early Glaucoma
Authors: Noureldin W O , Ebiary H M , Zaki R G 
Published: May 2020

Abstract

Purpose
To estimate the link between the thickness of retinal nerve fiber layer (RNFL); utilizing optical coherence tomography (OCT) and corresponding retinal sensitivity changes; utilizing visual field (VF) perimetry, in cases of ocular hypertension and early glaucoma.

Methods
Thirty patients (60 eyes) were gathered for this prospective, cross-sectional study. They were categorized into two groups. Group I comprised 30 eyes (15 patients) having ocular hypertension. Group II comprised 30 eyes (15 patients) early recognized as primary open angle glaucoma. Each patient underwent a thorough ophthalmologic examination, OCT for RNFL thickness estimation using quick RNFL thickness protocol and VF testing using automated perimetry (G2 program, central 30–2 threshold protocol). Pearson’s correlation was premediated between thickness of RNFL and VF indices.

Results
Significant connections between the thickness of temporal area of RNFL and mean sensitivity (MS), mean defect (MD) and loss of variance (LV) indices of VF (r = 0.533, -0.431, -0.388; P &lt; 0.01, respectively) were noticed in patients having ocular hypertension. Additionally, a significant link between the thickness of the temporal area of RNFL and MS index of VF (0.441; P &lt; 0.05) was noticed in patients with early POAG. Otherwise, there were no significant links between indices of VF and other areas of RNFL thickness in both groups.

Conclusion
Average RNFL thickness is certifiably not a dependable index for early determination of glaucoma or for the follow-up of ocular hypertension and POAG. Segmental RNFL thickness (especially temporal) appears to be a more dependable index. Profound structural modification with OCT test comprises an imperative sign of early utilitarian changes, regardless of whether they are not yet recognized with perimetry. The MS index of VF is by all accounts sensitive for the follow-up of ocular hypertension.