bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Lung Ultrasound in the Diagnosis of Neonatal Respiratory Disorders
Authors: El Raggal Nehal M , Hegazy laila A , Sakr Hossam M , Farid Yasmin A , Eldafrawy Osama A , Ismail Rania I 
Published: October 2021

Abstract
lung ultrasound (LUS) was used traditionally in the assessment of pleural effusions and masses but LUS has moved towards the imaging of the pulmonary parenchyma, mainly as a point-of-care technique.

Objective
To assess the agreement between LUS and CXR for the diagnosis of RD in neonates.

Methods
This prospective cross sectional study was conducted on 100 neonates presents with RD in the first 24 hours of life in the neonatal intensive care unit (NICU) of the Ain Shams University. All enrolled neonates underwent LUS and CXR initially and on day 7. Neonatologists were blind to the LUS diagnosis and the clinical decisions were driven by CXR findings. Lung score was applied to describe lung aeration, interstitial, alveolar, or consolidation patterns for each lung area.

Results
125 different diagnoses were reported in 100 patients. The total agreement between LUS and CXR diagnosis was 96% (95% CI 88–98%) with a κ statistic of 0.94 (95% CI 0.86– 1.00). The agreement for RDS, Pneumonia, TTN, MAS, CDH, PE, Pnumothorax and atelectasis were 99%, 96%,98%, 99%,100%,100%,98% and 98% consequently.

Conclusion
LUS is a safe, low coast, easy to operate and has high agreement with CXR for the diagnosis of RD in neonates in the first week of life.

Key words
Neonatal intensive care, Point-of-care ultrasound, Chest X-ray
Abbreviations: NICU: Neonatal Intensive Care Unit, LUS: Lung ultrasound, CXR: Chest X ray, RDS: respiratory distress syndrome, TTN: Transient Tachypnea of Newborn, MAS: Meconium Aspiration, PE: pleural effusion, CDH: cong. diaphragmatic hernia.
Phototherapy effect on CD4 lymphocytes of Full Term Neonates with Jaundice
Authors: El Farrash Rania Ali , Shinkar Dina Mohammed , El Dine Salem Dalia Ahmed Diaa , El Azazy Reem Khalid Said 
Published: October 2021

Abstract

Background
Neonatal jaundice is one of the most common problems that affect newborn infants, and phototherapy is usually used for treatment. Phototherapy is generally considered a very safe and well-tolerated treatment for hyperbilirubinaemia. However, clinical users should be aware of the unwanted effects of using phototherapy. Affection of neonatal immune system due to phototherapy has been reported.

Objectives
Evaluation of the effect of phototherapy on neonatal immune system through measuring the level of CD4+ lymphocytes.

Methods
A prospective cohort study was conducted on full term newborns assigned to three groups: group1 neonates with hyperbilirubinemia treated by conventional phototherapy, group2 neonates treated by LED phototherapy and healthy neonates as control group. The percentages and absolute counts ofCD4+ lymphocytes were measured by flow cytometry before phototherapy and 48 h after exposure.

Results
The study showed a significant decrease in CD4+ percentage in patients after 48 h of exposure to conventional phototherapy (P value &lt; 0.05). There was a significant decrease in CD4+ absolute counts after 48 h of exposure to both types of phototherapy.

Conclusion
Conventional and LED phototherapy which is used in the treatment of neonatal hyperbilirubinemia, caused a decrease in CD4+ absolute count 48 hours after phototherapy. Also conventional phototherapy caused a decrease in CD4+% 48 hours after exposure.
Effect of the loading dose of magnesium sulfate on the Doppler velocimetry parameters in the uterine, umbilical and fetal middle cerebral arteries in severe preeclampsia
Authors: ElKady Mohamed A , Rabie Noha H , Mostafa Mohammed H , Hafez Amany M 
Published: October 2021

Abstract

Background
Preeclampsia is pregnancy-specific syndrome of reduced organ perfusion secondary to vasospasm and endothelial activation.

Aim of the Work
to assess the effect of injecting magnesium sulfate on Doppler parameters of uterine artery, umbilical and fetal middle cerebral arteries (MCA) in women with severe preeclampsia.

Patients and Methods
This study included eighty pregnant with severe preeclampsia or eclampsia who were given magnesium sulphate therapy in Ain Shams University Maternity hospital. The Study group included 80 pregnant patients Doppler flow velocity parameters (resistance index [RI], pulsatility index [PI] and systolic/diastolic [S/D] ratio) were evaluated in the uterine, fetal umbilical and middle cerebral arteries before and 20 minutes after intravenous administration of 6 grams of magnesium sulfate (Loading dose).

Results
Magnesium sulfate had significant hemodynamic effects with significant reduction of systolic and diastolic blood pressure. Regarding the Doppler studies, it was found that after administration of magnesium sulfate there was significant reduction in the Doppler velocimetry parameters (Resistance index[RI], Pulsatility index[PI] and systolic/diastolic[S/D] ratio) in the uterine, umbilical and fetal middle cerebral arteries denoting decreased vascular resistance with increased blood flow in these vessels.

Conclusion
Intravenous administration of magnesium sulfate in pregnant women with severe preeclampsia and eclampsia resulted in a decrease in uterine artery, fetal umbilical and middle cerebral arteries Doppler indices with reduced resistance to blood flow in these vessels.
A comparison of the efficacy and safety of repetitive hourly dose of oral misoprostol and two hourly dose oral regimens for cervical ripening and labor induction: A R.C.T
Authors: Mohamed Sabry S , Mohammed Hayam F , Essam El Din Mansour Ahmed M , Hagag Essam S 
Published: October 2021

Abstract

Background
Labor induction most frequently conducted through interventional procedures, and their use has been increasing in the past several decades. In a survey by the National Center for Health Statistics the rate of labor induction was noted to have increased from 9.5% in 1991 to 22.5% in 2006. This randomized controlled trial was conducted at Ain Shams University Maternity Hospital (pre-labour ward) in the period between January 2019 and January 2020.

Patients and Methods
This study was conducted on 150 pregnant women attending Ain Shams University Hospital outpatient clinic, they were classified according to the indication for labor induction into 2 groups, high risk group and low risk group.

Results
that there was no statistically significant difference between groups according to baseline characteristics, indication of induction and need for oxytocin. Regarding medications side effect and maternal outcomes, our results showed that there was statistically significant difference between groups according to pyrexia. Regarding mode of delivery, our results showed that there was no statistically significant difference between groups. Regarding no. of req. doses and duration of delivery, our results showed that there was statistically significant difference between groups according to no. of req. doses and duration of delivery (hrs) and total dose of misoprostol (µg), more in group I (hourly dose) than II (2 hours dose). Regarding fetal outcomes (Apgar score at 1 and 5 min, birth weight (kg), meconium staining, NICU admission), our results showed that there was no statistically significant difference between 2 groups.

Conclusion
The repetitive hourly dose of misoprostol solution (10 μg -10 mL- oral misoprostol administered hourly up to12 doses) has similar efficacy as oral misoprostol solution every 2 hours (20 μg -20 mL- administered every 2 hours up to 6 doses) but with more side effects.
Letrozole Pretreatment With Misoprostol Versus Misoprostol Alone For Induction of First Trimesteric Missed Miscarriage A Randomized Controlled Trial
Authors: Moustafa Mohammed Hussein , Shahawy Yasser Mohammed El , Garas Peter Samir 
Published: October 2021

Abstract

Background
Miscarriage or spontaneous abortion is the involuntary termination of pregnancy before 20 weeks of gestation or a fetus born weighting less than 500 grams.

Objective
To compare between the safety and efficacy of two treatment modalities in medical termination of first trimesteric missed miscarriage.

Patients and Methods
This study was conducted at outpatient Obstetric clinic of Ain Shams maternity hospital in the period between June 2017 and December 2018. The patients who were fulfilling the inclusion criteria, were recruited in the study, then an informed consent was taken before starting the trial.

Results
In the total of 88 patients who were recruited in the study, 3 patients dropped from the study, 2 patients from the first group and 1 patient from the second group, so 85 patients were analyzed, the complete abortion rate of the letrozole group was significantly higher than that of the misoprostol only group (83.72% compared to 64.29%).

Conclusion
The use of letrozole pretreatment followed by misoprostol for induction of abortion in the first trimester is associated with higher complete abortion rate than misoprostol only.
Low level Laser Therapy versus Ultrasonic therapy for the Treatment of Shoulder Impingement Syndrome A Systematic Review of randomized controlled trials
Authors: El Tayeb Mahmoud N , Hassan Abrar A , Abuelnaga Yasmeen G , Eid Passant M , Tarkhan Yasmeen M , Fathallah Mahmoud M , Awad Ahmed A , Nabhan Ashraf F 
Published: October 2021

Abstract

Background
Shoulder impingement syndrome is a common cause of shoulder pain in primary health care settings. Many physical modalities of treatment are available in clinical practice, however there is insufficient evidence on their relative effectiveness. This review compares the effectiveness of Low Level Laser Therapy (LLLT) with ultrasonic therapy.

Objectives
To assess the effectiveness of LLLT vs. ultrasonic therapy in patients with subacromial impingement syndrome

Search methods
We searched Cochrane Central Register of Controlled Trials (CENTRAL) on the Cochrane Library, MEDLINE (Pubmed), Embase, Scopus. We searched trials registries on ClinicalTrials.gov (www.ClinicalTrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) Search Portal (apps.who.int/trialsearch/). We also hand-searched reference lists of all included primary studies, relevant conference proceedings and academic literature, and relevant systematic reviews (both Cochrane and non Cochrane), to identify additional studies missed from the original electronic searches (e.g., unpublished or in press citations). We did not use date or language restrictions.

Selection criteria
Randomized controlled trials comparing LLLT vs. US therapy in adult patients with subacromial impingement syndrome.

Data collection
Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information. We collected our primary outcomes information from the trials and assessed the quality of evidence for key outcomes using GRADE.

Results
We included 2 RCTs, contributing 67 participants to our qualitative synthesis. The overall risk of bias is high for both studies. Very low-quality evidence from 1 RCT shows slightly increased mean change in pain severity after LLLT compared to ultrasonic therapy in the short term (3 months) (MD 4.69, 95% CI -5.76 to -3.62).[13]. Very low-quality evidence from 1 RCT shows little to no difference in functional improvement after LLLT compared to ultrasonic therapy in the short term (after 3 months) (MD -0.63, 95% CI -5.53 to 4.27) [13]. No studies investigated Range of Motion in the short term. Verylow certainty evidence showed little to no difference in pain severity and function in the immediate post-treatment phase (up to 1 month). No studies addressed long term follow-up.

conclusion
There is insufficient evidence regarding the difference in effects between LLLT and Ultrasonic therapy for the treatment of shoulder impingement syndrome.
Ultrasound in Evaluation of Subclinical Enthesitis of Extensor Digitorum Tendon and Nail Unit Changes in Psoriasis
Authors: Sherif Nahed Mounir , Ali Elwi Mohamed , El Mallah Reem , Ali Mohamed Sara Samir 
Published: October 2021

Abstract

Background
Subclinical inflammation at entheseal level has been detected in patients with psoriasis without previous history of arthropathy or Psoriatic arthritis (PsA). Ultrasound (US) is a valid and sensitive tool for the assessment of inflammatory involvement at entheseal level in PsA patients.

Objective
To detect subclinical arthritis or enthesitis at distal interphalangeal (DIP) fingers and nail unit changes in psoriatic patient for early detection of PsA

Patients and Methods
This study included 30 adult psoriatic patients and 30 healthy matched controls. All underwent history, clinical examination, Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI) score calculation and musculoskeletal US both grey and power Doppler (PD) assessed at enthesis of extensor digitorum tendon insertion at distal phalanx, DIP joints from 2nd to 5th finger bilaterally examined for detection of synovitis and over the nail for morpho-structural evaluation.

Results
Patient’s ages ranged from 18-65 years and controls 20-60 years (mean ±SD 45.07 ± 13.52, 38.37 ± 11.96 respectively), male to female ratio 1:2. DIP joint affection in the form of synovial hypertrophy and effusion with PD was found in 13.3% of cases. Enthesophyte with PD in 56.7% of cases. On comparison between NAPSI score by clinical examination versus US examination, the sensitivity of US was 100%, all cases clinically positive by NAPSI were positively affected by US (20 cases). Also 30% of cases were negative by NAPSI and were positive by US (7cases). Three cases were negative by both NAPSI and US. A significant positive correlation was observed between disease duration and NAPSI Score (r = 0.429, pvalue&lt;0.05), similarly between presence of enthesophyte with PD and PASI Score (r = 0.547, pvalue&lt;0.02).

Conclusion
Detection of subclinical enthesopathy at DIP joint by ultrasound is not infrequent, so it is an important tool for examining enthesis in psoriatic patients. The presence of a high PASI score and long disease duration could be considered as predictive parameters for the presence of psoriatic enthesitis ongoing to arthritis.
Health Risks of Low Dose Of Ionizing Radiation Among Health Care Providers at ain Shams University Hospitals
Authors: Abbas D , Gabal MS , Ez- Elarab HS , El Khazragy NN , Manzour AF 
Published: October 2021

Abstract

Introduction
Ionizing radiation (IR) is an occupational hazard that can induce many health risks on exposed health care workers (HCWs). However, the health risks of low dose (below 100mSv) are controversial due to a lack of direct evidence on human.

Aim of work
To identify the health risks of exposure to low dose of ionizing radiation and its effect on general health status and to assess oxidative stress status of health care workers (HCWs) exposed to IR at Ain Shams University hospitals.

Materials and methods
A comparative cross-sectional study was conducted including 50 HCWs from different departments of Ain Shams University hospitals: exposed group (exposed to IR for at least I year) (No = 25) and matched unexposed control group (No = 25). Both groups were interviewed using a structured questionnaire. Assessment of health care workers' oxidative stress status was done for both groups by measure level of plasma malondialdehyde (MDA) level as biomarker for lipid peroxidation. Complete blood count was done for both groups. Recording readings of personal exposure to IR by badge film dosimeter after approval from workplace authority was also done.

Results
Regarding general health status and wellbeing of workers, most of exposed group had perception of average health status, while most of unexposed group had perception of good health status. A significantly higher sickness absenteeism during the last 6 months was found among the exposed group and a significant adverse health effects, were recorded among exposed group compared to control group as hair fall, musculoskeletal pain, pain in upper abdomen, constipation, decreased visual acuity, in addition to easily agitated. During the last 30 days exposed group had significantly higher frequencies of GIT disturbances and common cold or infections in comparison to unexposed group. The results showed that IR exposed group had the more oxidative stress status (higher level of plasma MDA) than unexposed group with significant difference (p value =0.014). Results showed also that the Mean Corpuscular Hemoglobin (MCH), Absolute lymphocyte and monocyte counts were significantly lower while relative basophile % was significantly higher among exposed group in comparison to unexposed group (although all parameters were within normal range in both groups).

Conclusion
Exposure to IR -even in small dose- may lead to significant health complains (adverse health effects), increase oxidative stress status and may affect general health status among exposed group compared to the non-exposed one.

Recommendations
Personal monitoring for ionizing radiation, periodic medical examination, and increasing level of protection for exposed workers are of utmost importance.
Reporting Medication Errors and Drug Therapy Problems Through the Egyptian National Electronic Reporting System in 56 Governmental Hospitals during 2019
Authors: AbdulAziz Hebatalla Mohamed , Mostafa Aya , Hakim Sally Adel , Moustafa Moustafa El- Houssine 
Published: October 2021

Abstract

Introduction
Several countries have adopted national reporting systems of medication errors such as in the UK and the USA. Egypt has a new national reporting system of medication error (MEs) & drug therapy problems (DTPs), the NO HARMe (the National Office for Handling And Reduction of Medication errors) since October 2017.

Objectives
To determine the most common types of MEs and DTPs encountered by clinical pharmacists as the NO HARMe users in governmental hospitals.

Methodology
We conducted a cross-sectional survey using a self-administered online questionnaire in fifty-six governmental hospitals where clinical pharmacists use the NO HARMe, from October to December 2019.

Results
Most (96%) of the 206 participating clinical pharmacists were females with a mean age of 32.8 years (SD 4.32). The most common departments where participants worked are adult ICU (32.5%), neonatal ICU (14.6%), pediatric ICU (7%), and internal medicine (5%). The most common types of DTPs & MEs reported by clinical pharmacists were inappropriate doses or dosing intervals (38.3%), drugs with no valid indications (25.2%), antibiotics without indication (17.5%), and inappropriate selection of an antibiotic (13.6%).

Conclusion
Medication errors in drug dosing are prevalent in the hospitals included in this study. Also, drugs that are prescribed without need, while errors in antibiotics were very common in many hospitals either prescribed for no need or selected inappropriately.
Pulled Diversification Rates, Lineages-Through-Time Plots, and Modern Macroevolutionary Modeling
Authors: Helmstetter Andrew J , Glemin Sylvain , Käfer Jos , Zenil-Ferguson Rosana , Sauquet Hervé , de Boer Hugo , Dagallier Léo-Paul M J , Mazet Nathan , Reboud Eliette L , Couvreur Thomas L P , Condamine Fabien L 
Published: October 2021

AbstractEstimating time-dependent rates of speciation and extinction from dated phylogenetic trees of extant species (timetrees), and determining how and why they vary, is key to understanding how ecological and evolutionary processes shape biodiversity. Due to an increasing availability of phylogenetic trees, a growing number of process-based methods relying on the birth–death model have been developed in the last decade to address a variety of questions in macroevolution. However, this methodological progress has regularly been criticized such that one may wonder how reliable the estimations of speciation and extinction rates are. In particular, using lineages-through-time (LTT) plots, a recent study has shown that there are an infinite number of equally likely diversification scenarios that can generate any timetree. This has led to questioning whether or not diversification rates should be estimated at all. Here, we summarize, clarify, and highlight technical considerations on recent findings regarding the capacity of models to disentangle diversification histories. Using simulations, we illustrate the characteristics of newly proposed “pulled rates” and their utility. We recognize that the recent findings are a step forward in understanding the behavior of macroevolutionary modeling, but they in no way suggest we should abandon diversification modeling altogether. On the contrary, the study of macroevolution using phylogenetic trees has never been more exciting and promising than today. We still face important limitations in regard to data availability and methods, but by acknowledging them we can better target our joint efforts as a scientific community. [Birth–death models; extinction; phylogenetics; speciation.]
Understanding the course of COVID-19-induced pneumomediastinum
Authors: Panico Rocco , Cai Jenny , Butts Christopher A. , To Jennifer Q. 
Published: October 2021

ABSTRACT
Since its discovery, COVID-19 has infected nearly 112 million people and caused about 2.5 millions deaths worldwide. Our understanding of the clinical presentation and complications of COVID-19 is still evolving. Bilateral pulmonary ground-glass opacities on imaging have become characteristic in the diagnosis of COVID-19, but pneumomediastinum has now also been reported in some patients with COVID-19. Reports on the overall prognosis for these patients are conflicting and little information exists regarding long-term complications. This article describes the clinical course of a patient who did not need mechanical ventilation but developed spontaneous pneumomediastinum.
Validity of Pulse Oximetry-derived Peripheral Perfusion Index in Pain Assessment in Critically Ill Intubated Patients
Authors: Abdelhakeem Amr K. , Amin Alya , Hasanin Ahmed , Mukhtar Ahmed , Eladawy Akram , Kassem Sahar 
Published: October 2021

Objectives:
Evaluation of pain in critically ill intubated patients is difficult and subjective. This study aimed to evaluate the accuracy of oximetry-derived peripheral perfusion index (PPI) in pain assessment in critically ill intubated patients using the behavioral pain scale (BPS) as a reference.

Materials and Methods:
This prospective observational study included 35 adult mechanically ventilated surgical patients during their first 2 postoperative days in the intensive care unit. Values of PPI, BPS, Richmond Agitation Sedation Scale (RASS), heart rate, and blood pressure were obtained before and after a standard painful stimulus (changing the patient position) and the ratio between the second and the first reading was calculated to determine the change (Δ) in all variables. The outcomes were the correlation between ΔBPS and ΔPPI as well as other hemodynamic parameters. The ability of the PPI to detect pain (defined as BPS ≥6) was analyzed using the area under receiver operating characteristic curve.

Results:
Paired readings were obtained from 35 patients. After the standard painful stimulus, the PPI decreased while the BPS and the Richmond agitation sedation scale increased. The Spearman correlation coefficient (95% confidence interval) between Δ PPI and Δ BPS was 0.41 (0.09-0.65). PPI values showed poor accuracy in detecting pain with area under receiver operating characteristic curve (95% confidence interval): 0.65 (0.53-0.76), with best cutoff value of ≤2.7.

Conclusion:
The PPI decreased after application of a standard painful stimulus in critically ill intubated patients. ∆PPI showed a low correlation with ∆BPS, and a PPI of ≤2.7 showed a low ability to detect BPS ≥6. Therefore, PPI should not be used for pain evaluation in critically ill intubated surgical patients.