bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Risk Scoring Model for Prediction of Endometrial Cancer Among Symptomatic Postmenopausal Women (A Prospective Cohort Study)
Authors: Abd Elgawaad Magdy M , El Helaly Amr M , Faisal Malames M , Kasem Asmaa F 
Published: October 2021

Abstract

Background
Endometrial carcinoma is the most common gynecological malignancy in the developed countries and the third common gynecological malignancy in Egypt after breast and ovarian cancers.

Aim of the Work
to evaluate this risk scoring model on Egyptian patients and to study the effect of adding other patient characteristics (DM, BMI and relevant family history) on the sensitivity and specificity of RHEA scoring model.

Patients and Methods
The current study was conducted in Ain Shams University Maternity Hospital in the period between September 2017 and December 2018. A total of 100 women with postmenopausal bleeding and endometrial thickness &gt; 4mm were included in the study.

Results
Histological examination revealed that benign pathology (n = 65) (73%) was found to be: most common cause was endometrial hyperplasia without atypia (20.3%) followed by chronic endometritis (13.5%), then endometrial polyp (11.3%), cystic atrophy of endometrium (8.9%), proliferative endometrium (8.9%), endometrial hyperplasia with atypia (6.7%) and lastly mucous polyp (3.4%) while malignant histopathology(n = 24)(27%) which is significantly higher than the international rates showed: Endometriod adenocarcinoma (n = 19)(21.3%), papillary serous carcinoma (n = 4)(4.5%) and undifferentiated carcinoma (n = 1)(1.1%). The current study showed that RHEA score performs in our study population with a comparable validity to that reported by its inventors with sensitivity 79.2% (57.8% - 92.9%) vs. 87.5% and specificity 84.6% (73.5% - 92.4%) vs. 80.1% respectively. In results of the current study it was found that the time since onset of menopause rather than age was associated with endometrial cancer with the optimum cut-off for postmenopausal duration was estimated to be 9 years achieving a sensitivity of 87.5% and a specificity of 60.0%, but it needs multivariate analysis on larger and more representative sample size to confirm this association, A statistically significant regression model was including only postmenopausal duration, recurrent bleeding and endometrial thickness. None of age, BMI, family history or hypertension proved a statistically significant predictive effect after adjustment for other predictive variables.

Conclusion
Taking in consideration the higher prevalence of endometrial carcinoma in the sample of the current study, the wide 95% confidence intervals for the different validity indices for the RHEA scores derived from this study, it seems that RHEA score performs in this study population with a comparable validity to that reported by its inventors.
Effect of Metformin on Chemical Pregnancy Rate in women with Unexplained Infertility (A randomized controlled trial)
Authors: Fathy Hisham M , BahaaEldin Ahmed M , Safwat Sarah , Mohammed Elham R 
Published: October 2021

Abstract

Background
There is controversy regarding treatment of unexplained infertility due to absence of specific pathophysiological rational which allows curative intervention. The main three lines of treatment of such cases are confrolled ovarian hyperstimulation, IUI with spontaneous or induced ovulation and third is IVF.

Aim of the Work
to evaluate the effect of metformin on chemical pregnancy rate in women with unexplained infertility. Patients and Methods: This was a prospective randomized controlled trial study which was conducted on 170 women with unexplained infertility in Ain Shams Maternity Hospital.

Results
:. Incidence of chemical pregnancy was not statistically sigfificantly different between both groups (PR: 18.8% vs.16.5% P 0.84) in metfonnin and clomiphene y•oup respectively. (NNT) was estimated to be 42.5.

Conclusion
our study showed little benefit was added to the patients by using metfonnin as adjuvant therapy to clomiphene citrate during ovulation induction as regards chemical pregnancy. 42 women are needed to be freated with metformin to get one more pregnant woman by pregnancy test
Effect of Follicular Fluid Estradiol Level on Oocyte Quality, Fertilization and Pregnancy Outcome in Intracytoplasmic Sperm Injection Cycles
Authors: Al-Kady Mohamed A , Mostafa Mohamed H , Mansour Dina Y , Mohamed Noha R , Ahmed Heba A , Rushdy Emad E 
Published: October 2021

Abstract

Background
Infertility is the third most serious disease worldwide estimated by the WHO. Despite the worldwide use of ICSI, it still has a low birth rate (30%).

Patients and Methods
The current study was a prospective study that included 180 women undergoing Intra-cytoplasmic sperm injection (ICSI) procedure. Using Flexible Antagonist protocol; during oocyte retrieval, follicular fluids of mature follicles (&gt;17 mm) aspirated.

Results
The number of retrieved oocytes ranged from (1 to 33 oocytes) mean number 10±7. Follicular fluid E2 concentration ranged from 246±199 (0 to 700) (ng/ml). Oocyte maturation about 116 were MII (64.4%) of oocytes. And 64 (35.6%) were MI and GV. 107 cases (59.4) had normal fertilization lamos_zzzz@hotmail.com and 73(40%) had abnormal fertilization of MII injected oocytes. Embryo quality 63.9% (115) of fertilized MII oocytes were blastocysts and 65 (blastomere and others) and 60.6% of cases had embryo transfer on day 5 and 39.4 had transfer on day 3. Chemical pregnancy was positive in 85 cases (47.2%) and the clinical pregnancy positive in 66 cases (%).

Conclusion
Follicular fluid E2 concentration had fair predictive value in oocyte maturation, fertilization, embryo quality, chemical and clinical pregnancy. But it was an independent predictor of MII-grade oocytes production.
Cesarean section incisional infiltration with lidocaine and Epinephrine versus Lidocaine alone in reducing postoperative pain. A randomized controlled double-blinded clinical trial
Authors: El-Shahawy Hazem F , El-Mekkawi Sherif F , Mohmmed . Haitham F , Afifi Hend M 
Published: October 2021

Abstract

Background
Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation

Aim of the Work
to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia.

Patients and Methods
A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only.

Results
women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia.

Conclusion
Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000
Analysis of Cesarean Delivery at Ain Shams Maternity Hospital Using the Ten Group Classification System
Authors: Elzenini Hazem Amin , Mansour Radwa , Elnagar Ismail Mohamed Ismail 
Published: October 2021

Abstract

Background
Cesarean section is an invasive surgical procedure in which a baby is delivered through an abdominal and uterine incision & carries with it many immediate and delayed morbidity and mortality risks.

Objective
To evaluate the feasibility of using the Robson Ten Group Classification System (TGCS) for cesarean delivery indications at Ain Shams Maternity hospital.

Methods
This is a retrospective study on women who delivered by cesarean delivery at Ain Shams Maternity hospital between July 1, 2016 and June 30, 2018. All patient files have been revised and data has been collected then categorized. The indications for this mode of delivery: suspected fetal growth impairment, fetal distress, preeclampsia/eclampsia, pregnancy duration in weeks or more pre-partum hemorrhage, cephalopelvic disproportion, dystocia, failure of progress, multiple pregnancy, suspected/imminent uterine rupture, breech or other malpresentations, previous cesarean delivery, failed induction of labor, tubal ligation, sterilization, maternal request genital herpes, extensive condyloma, any other obstetric complication, any other fetal indication or any other maternal medical complication.

Results
15808 women delivered in the hospital during the study period, The CS rate was 58.04%. According to the Robson classification, Group5 and Group 10 were the most represented groups (31.72% and 29.91% of population, respectively). The major contributors to the CS rate were group 5 (27.10%), group10 (14.02%).The most commonly reported indications for CS included past CS, suspected fetal distress, preeclampsia, eclampsia.These suggested the need for further discussion on CS practices

Conclusion
This study provides an example on how the WHO manual for Robson classification can be used in an action-oriented manner for developing recommendations for improving the QoC, and the quality of data collected.
Intravenous Dexamethasone Versus Vaginal Misoprostol in Enhancing Cervical Ripening and Labor Induction
Authors: Salman Mohamed Mahmoud , Salama Fekria Ahmed , Yacoub Mina 
Published: October 2021

Abstract

Background
Induction of labor is one of the most common procedures performed in the world of Obstetrics. Traditionally, labor induction is performed using prostaglandin and oxytocin. However, usage of corticosteroids nowadays is gaining a lot of interest regarding its effects on cervical ripening and shortening the physiological process of labor.

Aim of work
to evaluate the efficacy of intravenous dexamethasone versus vaginal misoprostol in enhancing cervical ripening and labor induction.

Patients and Methods
A randomized controlled clinical trial was carried out at Ain Shams University Maternity Hospital on (60) full term pregnant women between 39 – 42 weeks undergoing induction of labor, during a period from April 01, 2019 to November 30, 2019. Pregnant women were divided into two groups; vaginal misoprostol (control) group and intravenous dexamethasone (experimental) group (30 cases each).

Results
Our study showed that the mean time interval (hours) from initiation of labor induction to initiation of active phase was statistically significantly shorter among the dexamethasone (experimental) group 7.36 ± 2.23 versus 12.20 ± 4.92 hours among the vaginal misoprostol (control) group (p value &lt; 0.001). Also, the mean time interval of the total duration between the induction of labor to successful vaginal delivery was statistically significantly shorter among the dexamethasone group 10.90 ± 4.17 versus 19.20 ± 5.62 hours among the vaginal misoprostol group (p value &lt; 0.001). The results of this study showed the rate of initiation of active phase and rate of successful vaginal delivery were more in the experimental dexamethasone group than the control vaginal misoprostol control group.

Conclusion
Intravenous injection of 8 mg of dexamethasone before induction of labor is found to shorten the duration of labor induction by reducing the time interval between the initiation of labor induction and onset of active phase and the total duration from initiation of labor induction to delivery with no marked maternal or fetal complications.

Recommendations
Intravenous Dexamethasone can help cervical ripening and accelerate induction of labor. Further research should be taken in consideration with more population for more global evaluation.
Transvaginal sonographic assessment of the cervix for prediction of successful induction of labor in nulliparous women
Authors: Abd-Elhafeez Mohammed Abd-Elhameed , Elguindy Alaa Eldin , Hamed Mohamed Abu El Fetoh Mohamed , Nawara Maii 
Published: October 2021

Abstract

Background
Induction of labor is commonly performed in obstetric practice. Many methods have been suggested as good predictors of the outcome of labor induction, yet none of them is satisfactory enough.

Objective
To assess cervical length and uterocervical angle measured by transvaginal ultrasound as predictors of successful induction of labor.

Methodology
Prospective cohort study was conducted in a university-affiliated hospital over 150 nulliparous women undergoing induction of labor, in the period between May 2018 and August 2019. Transvaginal sonographic measurement of cervical length and uterocervical angle was done before induction of labor by prostaglandins. The patients were followed up till delivery and the outcome was recorded.

Results
The best cut-off value of cervical length for prediction of success of labor induction was 32.3 mm with 60% sensitivity and 56% specificity and the best cutoff value of uterocervical angle was 110.2 degrees with 87% sensitivity and 93% specificity. The cervical length showed a significant negative correlation while the uterocervical angle showed a significant positive correlation with the success of labor induction.

Conclusion
Cervical length and uterocervical angle are good predictors of successful labor induction.
Efficacy and Safety of Different Doses of Vaginal Misoprostol Prior to Intra Uterine Contraceptive Device Insertion: A Randomized Double-Blind Clinical Trial
Authors: Helmy Shaimaa G , El-Kadi Mohammed A , Elhodiby Mohamed E , Salama Mohamed H 
Published: October 2021

Abstract

Objective
This study aims to compare the efficacy and safety of different doses of vaginal misoprostol prior to IUCD insertion among women with nulliparous cervix “those who 29never delivered-vaginally”. Study design: The current study was a randomized, double-blind, placebo-controlled trial conducted in the Family Planning Clinic of Ain Shams University’s Maternity Hospital Egypt. It involved women who delivered only by elective CD (cesarean delivery). One hundred and eighty women were randomized into three groups, Group 1 received misoprostol 200 mcg. Group 2 received misoprostol 100 mcg. Group 3 received placebo. The primary outcome was pain scores which were measured using a visual analogue scale (VAS), the secondary outcome was the ease of insertion score (ES).

Results
VAS and ES were significantly lower in group 1 compared to group 2 and group 3 (P &lt; 0.001).There was insignificant difference among the three groups as regards successful IUD insertion (P = 0.477). Duration of insertion was significantly lower in group 1 than group 2 (P &lt; 0.001). Satisfaction was significantly higher in group 1 compared to group 2 and group 3 (P &lt; 0.001)

Conclusion
The effect of misoprostol seems to be dose-dependent. Dose of 200mcg seems to be ideal with best efficacy and with no significant increase in the adverse effects Implications: The dose of 200mcg vaginal misoprostol prior to IUD insertion in women, who had never delivered vaginally before, seems to be the most effective dose. Trail to lower the dose to100mcg significantly compromises the efficacy without remarkable benefit on the side effect profile.
The role of urinary Retinol binding protein (RBP) as a novel biomarker in early detection of kidney affection in patients with psoriatic arthritis
Authors: Ibrahim Dina Ahmed Abdel Moneim , Saleh Hala Abdul Hady , Saber Nayera Zaghloul 
Published: October 2021

Abstract

Background
PsA is a chronic multisystem inflammatory disorder with various systemic diseases. Renal involvement in patients with PsA is sparsely studied and its association is still unclear. This entity is called “Psoriatic Nephropathy”. RBP has been proposed as the most sensitive marker for detection of renal tubule function loss.

Aim
We aim at early detection of renal tubular damage by measuring the level of urinary RBP as a novel biomarker in patients with psoriatic arthritis in relation to activity and severity.

Methods
We conducted a Cross-sectional study of 30 PsA patients from Physical Medicine, Rheumatology and Rehabilitation and Dermatology outpatients’ clinics at Ain Shams University Hospitals. They were subjected to full medical history taking and thorough clinical examination with calculation of DAS 28, PASI and HAQ scores. Full Laboratory evaluation included CBC, ESR, CRP, serum creatinine, BUN, SGOT, SGPT, urine analysis, estimated GFR (eGFR) and urinary RBP were measured for all the participants. The urinary RBP and eGFR were compared with 30 age and sex matched healthy controls.

Results
The urinary RBP mean±SD (ng/ml) was found to be 351.667±119.397 in patients and was statistically significantly higher in them than in controls 93.16±30.836 (t = 11.482, p &lt; 0.001) and it was statistically significantly correlated with disease duration, disease activity according to DAS 28 and the severity of skin affection according to PASI score. While eGFR (ml/min) was found to be 131.729±28.943 in patients and it was statistically significantly lower in them than in controls 146.708±16.607 (t=-2.459, p = 0.017), however there was no statistically significant correlations with either DAS 28 or PASI scores.

Conclusion
Urinary RBP has been described as a novel biomarker in early detection of kidney affection and renal tubular damage in psoriatic arthritis patients.
Anti carbamylated protein antibodies as a diagnostic marker in patients with rheumatoid arthritis and its association with disease activity
Authors: El debsy Magda Medhat Awad , Hakim Mervat Mohammed Abdul , Khaled Henaz Farouk , El Sabour Sabbah Hala Mohamed Abd 
Published: October 2021

Abstract

Background
Despite the diagnostic contribution of anti-citrullinated protein( anti-CCP) antibody and rheumatoid factor (RF), approximately one-third of patients with rheumatoid arthritis (RA) remain seronegative .Anti-carbamylated protein (Anti-Carp) antibodies have been attracting increasing attention as a new diagnostic marker of RA.

Objective
evaluate levels of anti-carp antibodies in RA patients in order to detect its role as a diagnostic marker and its possible association with disease activity and severity.

Methods
This study included thirty adult patients with clinical evidence of rheumatoid arthritis and thirty healthy matched age and sex as controls. All underwent history taking, clinical examination, assessment of disease activity with modified Disease Activity28 (DAS28), Laboratory investigations including Complete blood count (CBC), erythrocytes sedimentation rate (ESR), C-Reactive Protein (CRP), Liver function tests, Kidney function tests, Serum uric acid, RF, anti CCP Ab, anti-Carp Ab and radiographic Assessment with Larsen score.

Results
Plasma levels of anti-Carp Ab were significantly higher in patients than control group (p &gt; 0,001) with sensitivity of 73.33% and specificity of 100%.it showed significant positive correlation with CRP (r = 0.37 )(p &lt; 0.05) as a marker of activity of RA and also there was significant positive correlation with RF and ACPA (r = 0.45)(r = 0.48) (p &lt; 0.05) respectively as a diagnostic marker for RA. Plasma levels of anti-Carp Ab were higher in patients with more joints damage and erosions as assessed by Larsen radiological score as there was a highly significant correlation between Larsen score and serum Anti-Carp(r = 0.61)(p &lt; 0.001)..

Conclusion
serum Anti–Carp antibody level was higher in RA patients which serve as a diagnostic marker for RA, also its significant correlation with CRP and Larsen score may serve as a marker for disease progression and severity.
Awareness about the New Social Health Insurance System, among Physicians in Primary Health Care Centers in Cairo governorate, and Factors Affecting it
Authors: Soliman M , Gaafary M , Nabih D , Rady M 
Published: October 2021

Abstract

Introduction
The Government of Egypt is committed to attain Universal Health Coverage (UHC), and its progress in this vein has been spurred recently through the approval of the Social Health Insurance (SHI) law. Health providers are important stakeholders in the implementation of the SHI system.

Objective
The objective of this study was to estimate the level of awareness of physicians and managers in Primary Health Care Centers (PHCCs) in Cairo governorate about the new system and the factors affecting it.

Method
A cross-sectional study was conducted to estimate the awareness level of 100 physicians and managers from PHCCs in Cairo governorate in 2019. PHCCs subjected to this study were selected randomly from the official list of the PHCCs in Cairo governorate from the MOH, and the required sample of physicians was randomly selected inside each center. A semi-structured Arabic interview questionnaire was used, with a reliability coefficient of 0.70.

Results
The study revealed that the respondents’ awareness level of the new SHI System was mostly average (78% between Q1-Q3 of the total awareness score). Only 54% of the participants considered themselves aware of the new SHI system. 82% of the respondents expressed their desire to get more information about the new SHI system. The majority of participants (88%) reported that they did not attend any induction or training courses regarding the SHI system. Only 4% of the respondents stated that they are fully and clearly aware of their role in the new SHI system. Managers and older participants showed significantly higher means of awareness than the competitors groups.

Conclusion
The study concluded that the level of awareness about the SHI among the studied sample of the PHCCs physicians at Cairo governorate was averaged. Recommendation: Efforts should be enhanced for reaching out to the physicians in PHCCs, including those working in governorates where implementation of SHI system hasn’t commenced yet, especially to emphasize their understanding of the objectives and elements of the new system.