bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of Bench Training Model for Cleft Palate Surgery
Authors: Masoud Karim Samir , Ghanem Mohamed Abdel Mohsen , Hweidi Ahmed Sobhi , Zidane Ahmed Mostafa El Sayed 
Published: October 2021

Abstract

Background
Cleft palate is one of the most common congenital malformations worldwide. It can be non-syndromic or it can appear as a part of a syndrome or recurrence pattern.

Aim of the Work
To provide a valid life-size realistic training model of cleft palate surgery that aids in pre-operative training of residents and improvement of their skills in life surgery.

Patients and Methods
This interventional pilot study was done after approval of institutional ethics committee in Ain Shams University Hospitals operating theatres and in plastic surgery department’s skill lab for 6 months and obtaining an informed written consent from parents. It was designed to develop a bench model of cleft palate for pre-operative training of surgeons and assess its validity.

Results
In our study we found that the performance of trainees after using our developed bench model of cleft palate shows statistically significant improvement according to GRITS score by 63.2% compared to those who proceeded to live cases directly without training

Conclusion
This study further demonstrates the effective use of a novel cleft palate bench model as a training tool. After a single session, we observed improvement in cleft palate procedural skills, confidence, knowledge and time taken to finish the operation among trainees both with and without previous cleft experience. Additional research is needed to assess the durability of these improvements over time, and also the benefit of additional sessions with the bench model.
Open Reduction and Internal Fixation Using Plate and Screws Versus Percutaneous Kirschner Wires Fixation for Second and Third Metacarpal Bones Fractures: A Meta-analysis
Authors: Masoud Karim Samir , El Sherif Ahmad Fathi , Tallal Raghda Elsayed , Mohamed Waly Mahmoud Mahrous 
Published: October 2021

Abstract

Background
Metacarpal fractures are among the most common fractures of the skeletal system and account for 36 % of hand and wrist fractures.

Aim of the Work
To determine the functional outcome and postoperative complications for both these surgical techniques in the treatment of second and third metacarpal bones fractures.

Patients and Methods
The systematic review was restricted to clinical studies of both these surgical techniques in the treatment of closed second and third metacarpal fractures. We reviewed studies that include management of metacarpal fractures with open reduction and internal fixation using plate and screws versus percutaneous crossed Kirschner wires fixation.

Results
No specification was made about the type of fracture, other than shaft fractures located in the second and the third metacarpal. All fractures were operated because of instability, angulations’ or rotational deformity. No comparison can therefore be made between fracture type (i.e. spiral, oblique) and functional results. As all studies reported identical indication for surgical fixation a comparison between type of fixation and functional result can be made.

Conclusion
Based on the reported results there is no evidence to suggest one fixation technique over another. The reported complications however for ORIF and K-wire fixation in the treatment of metacarpal fractures are unmistakably different for the two types of fixation.
Spectrum of 18F-FDG PET/CT extranodal findings in lymphoma
Authors: Hussein Ahmed Mohamed , Kamel Omar Farouk , Lotfy Abeer Gamal 
Published: October 2021

Abstract

Background
Extranodal lymphoma can be the primary presentation or secondary to systemic involvement of lymphoma. Positron emission tomography with computer tomography (FDG-PET/CT) is useful in detecting extranodal sites during staging, treatment response assessment or recurrence detection in patients with lymphoma.

Objective
To demonstrate the PET/CT imaging appearances of extranodal lymphoma.

Methods
A descriptive retrospective study, conducted at Ain Shams University hospitals on 40 Patients with different types of lymphoma enrolled in this study over a period of six months starting from December 2018 to May 2019 at Ain shams university hospitals.

Results
The 40 patients involved in this study showed 58 extranodal lesions in 19 different extra-lymphatic sites, where the most frequently impacted sites were bone and bone marrow (20.7%) while supraglottic larynx, oesophagus and para vertebral sites are the least affected (1.7% each).

Conclusion
Knowledge of the imaging appearances of extranodal lymphoma can aid in the differential diagnosis of mass lesions encountered in tissues throughout the body on PET/CT.
Role of diffusion-weighted MR imaging in differentiation between malignant and benign portal vein thrombosis in patients with Hepatocellular carcinoma
Authors: Hussien Ahmed Mohamed , El Sayed Allam Allam , Moharram Amr Mohamed Kamal 
Published: October 2021

Abstract

Background
Differentiation between malignant and bland thrombus of the portal vein in patients who have HCC using diffusion weighted MR imaging.

Objective
To determine the role of DW imaging in differentiating between the benign and malignant portal vein thrombosis in patient with HCC.

Patients and Methods
This is a retrospective study done in ain-shams hospitals and private centers. This is a retrospective study done in Ain-Shams Hospitals and private centers. We studied 20 cases, 13 males and 7 females with total mean age 59.5.

Results
Our study had some limitations. First, we did not use pathologic findings as our reference standard for characterizing the thrombi; instead, we have used accepted imaging criteria as a reference standard. In our study, we used oval ROI placement and although we avoided averaging ADC of the thrombus with the surrounding structures “by enlarging the images and placing the ROI within the thrombus “, we cannot completely exclude that some averaging could have occurred in the smallest thrombi.

Conclusion
In addition to the initial diagnosis of the PVT nature, subsequent contrast-enhanced MRI is actually necessary to evaluate further treatment response in daily routine. But the administration of I.V. contrast agent is problematic especially in patients with renal insufficiency. Therefore, DWI technique can be utilized in adjunction with routine MRI protocols to determine the nature of PVTs by the calculation of ADCs values.
Sonographic and Duplex Evaluation of Synovial activity in Wrist and Hand Joints in Rheumatoid Arthritis
Authors: Ibrahim Ekhlas Hassan , Allam Khaled Esmat , Hassan Rasha Mohammed , Bassiouny Ahmed Mohamed 
Published: October 2021

Abstract

Background
Rheumatoid arthritis is a long-term autoimmune disease and inflammatory disorder. The damaging effect on cartilage, bone, ligaments, and tendons has raised the importance of the accurate diagnosis of structural damage, disease activity and severity assessment to enable therapeutic decisions and to evaluate disease outcome. US is non invasive, relatively cheap and widely accessible imaging tool that facilitates the detection of synovitis joint effusin and erosions more better than clinical, laboratory investigations alone and x-ray.

Aim of the Work
assess the role of of gray-scale and Doppler ultrasound early detection and characterization of synovitis and structural bone changes in wrist and hand joints in patients with Rheumatoid Arthritis by comparing qualitative and quantitative US parameters with clinical and laboratory indicators of disease activity.

Patients and Methods
A cross sectional study conducted onthirty five adult patients with RA . All the patients were diagnosed according to the 2010 ACR/European League . The patients were recruited from the Rheumatology and Rehabilitation Outpatient Clinic, Faculty of Medicine, Ain Shams Hospitals .The study was approved by the ethical committee, and consents were taken from all patients enrolled in the study. Patients assessed by history taking, Clinical examination, Laboratory investigations and US gray scale and US power Doppler was done for each patient.

Results
This study included 35 patients with established RA, 27 females (77.1%) and 8 males (22.9%). Ranged in age between 20-70 years with mean age [45.66±12.76],the mean CDAS28 was [4.62±1.37], ESR [44.93±20.79], CRP [15.92±9.03], 33 patients (94.3%) were found to have synovial thickening, 14 patient (40%) were found to have increased vascularity by PD, joint effusion was detected in 12 patient (34.3%) particularly in MCP joints, 13 (37.1%) had bone erosion and only 9 patients (25.7%) had Tenosynovitis, most of them were detected at the extensor compartment of the wrist joint.positive correlations found between the clinical disease activity indices, laboratory investigations, duration of illness and components of the US findings.

Conclusion
Ultrasound is non invasive, relatively cheap and widely accessible imaging tool that facilitates the detection of synovitis and erosions,, high resolution gray scale images combined with Doppler technique have made it possible to detect slow low volume blood flow, thus improving the outcome of the standard clinical assessment in Rheumatoid synovial inflammation.
Role of High Resolution Ultrasound and Magnetic Resonance Imaging in Traumatic Soft Tissue Injuries of the Wrist and Hand
Authors: Guirguis Mounir Sobhy , Sakr Hossam Moussa , Atiyya Ahmed Naeem , Mohammad Shaimaa Abdelsattar , Mostafa Ghada Yahia Hassanien 
Published: October 2021

Abstract

Aim of the Work
To assess the role of ultrasound in the diagnosis of traumatic soft tissue injuries of hand and wrist.

Patients and Method
This study includes 30 patients with a mean age of 42.17 years ±9, all with history of traumatic soft tissue injuries in hand and wrist, all patients underwent ultrasound and MRI. The U/S&MRI diagnostic criteria of each patient were analyzed, compared and correlated with clinical diagnosis/ or operative findings .

Results
A comparison of the sensitivity of US versus MRI was done by correlating the final diagnosis of each modality with clinical diagnosis and/or operative findings. In general as regard all types of soft tissue injuries we found that, in correlation with clinical diagnosis US gives (93.3% sensitivity), while MRI gives (73.3% sensitivity). US & MRI result shows agreement in detection of all types of post traumatic soft tissue injuries except in chronic tendinopathy, tendon fibrosis ,and chronic tendon tear heals by fibrosis we found no agreement between them (in which ultrasound can diagnose them, while MRI couldn’t detect them).

Conclusion
Ultrasound shows higher sensitivity in diagnosis of soft tissue injuries of hand and wrist than MRI, as compared to operative findings and /or clinical data.
Role of pet/ct in detection of tumor of unknown origin
Authors: Elsayed Khadija R , Allam Khaled E , Kamel Omar F , Soliman Ahmed H , Elsayed Huda F 
Published: October 2021

Abstract

Purpose
To evaluate the role of combined positron emission tomography and computed tomography (PET/CT) imaging in the detection of tumors of unknown origin.

Methods
This study included 20 cases presented with pathologically proved metastases of unknown primary or with clinic-radiological suspicion of metastases with unknown primary.

Results
The number of patients with true positive primary tumor sites was 14 (70%), 2 patients with false-positive results (10%), 2 patients with true negative results (10%) and 2 patients with false-negative results (10%). A sensitivity of 87.5% was achieved, with a specificity of 50% and a total accuracy of 80%. The Positive predictive value was 87.5%%, while the negative predictive value was 50%. The detection rate of the origin of the primary tumor was 70%.

Conclusion
whole-body FDG-PET/CT has to be considered a useful tool in evaluating metastases from UPT, allowing identification of primary tumors and modifying the stage of the disease and affect the management.
Role of MRI in Cerebral Venous Thrombosis
Authors: Geneidi Eman Ahmad Shawki , Keriakos Nermeen Nasry , Khaled Khaled Mostafa Mohammad 
Published: October 2021

Abstract

Background
Cerebral venous thrombosis CVT is a type of stroke where the thrombosis occurs in the venous side of the brain circulation, leading to occlusion of one or more cerebral veins and Dural venous sinus. CVT is a potentially life-threatening disease, accounting for approximately 0.5 % of stroke cases.

Aim of the Work
The aim of this subject is to illustrate the various aspects of CVT on MRI.

Patients and Methods
This is a retrospective study included 30 patients (19 females &11 males), their ages range from 3 months to 74 years with the median age 22 years. Mean age 22.04 years. The study was performed in radiology department El Demerdash Hospital between March 2018 & September 2019. The study included patients presented to the Medical Imaging Department of Ain Shams university Al-Demerdash hospital with cerebral venous occlusion neurological symptoms or imaging diagnosis.

Results
In our study,. Most common presenting symptom was headache noted in 22 patients (73.3%) followed by eye manifestations (blurring of vision or clinically having papilledema) was the second most seen in 18 patients (60%). Then comes convulsions in8 patients (26.7 %), Limb weakness in 5 patients (16.7%), finally disturbed consciousness level in 4 patients (13.3%). Most common mode of onset was subacute which was seen in 16 patients (53.3%) acute onset was seen in 6 patients (20%) as predominantly isointense on T1 weighted images and hypo intense on T2 weighted images, chronic onset was seen in 8 patients (26.7%) as hypo intense signal in both T1 and T2 WIs. MRV successfully diagnosed occlusion in most cases by absence of signal intensity with consequent non-visualization of occluded sinuses or veins in almost all patients and except 3 patients; those were having just cortical veins thrombosis detected by T2* sequence electing blooming artifacts with intact sinuses, and dilated distal collaterals seen in 18 patients.

Conclusion
Dural venous occlusion can occur due to many factors as thrombosis, inflammatory conditions of the brain and tumors. Cerebral venous thrombosis (CVT) has long been a neglected entity because of complexities in diagnosis and non-specific clinical presentation. Conventional MRI and phase contrast MRV in conjugation with recent techniques such SWI & DWI were considered more accurate diagnostic tool, non invasive, non ionizing, with high resolution in evaluating patients with suspected cerebral venous occlusion or thrombosis. It is also considered very useful to demonstrate brain parenchymal affection, the age or stage of the thrombus and its extension
The Diagnostic Value of Normalized ADC Using Spleen As A Reference Organ In Assessment Of Liver Fibrosis
Authors: Kamal Omina Ahmed , Ahmed Aya Yassin , Ali Mona Mohamed , Mostafa Mai Ahmed 
Published: October 2021

Abstract

Objectives
To investigate the value of liver ADC normalization using spleen as a reference organ in liver fibrosis assessment, in comparison with transient elastography (Fibroscan).

Materials and methods
A total of 60 participants were included,30 HCV positive patients and 30 in the control group. We calculated mean Spleen apparent diffusion coefficient (ADC), liver mean ADC and normalized liver ADC (defined as the ratio of Liver ADC to spleen ADC) which were compared between cirrhotic patients and the control group. Data was analyzed and ROC was used to evaluate the performance of nADC.

Results
No significant difference between spleen ADC values of patient group and control group or in-between different fibrosis stages. A significant negative linear correlation between control and patient groups using ADC (r = -0.900; p = 0.0374) or nADC(r=-1:p&lt;0,001).We also found that the mean liver ADC and nADC value in patients with hepatic fibrosis was significantly lower than that of volunteers (1.53 × 10 − 3 mm2/s vs.1.65 × 10 − 3 mm2/s, p = 0.001 &1.). Liver ADC only could distinguish F0 from F4. After analysis with ROC, there was a statistically significant difference between area under the receiver operating characteristic curve (AUC) of normalized liver ADC and ADC for all groups except for F4 stage. nADC AUC was 0.878 for detection of stage ≥ F2 with sensitivity and specificity of 87% & 80% respectively while ADC AUC was 0.548 with sensitivity and specificity of 62 % & 72% respectively(p = 0.021), ≥ F3 AUC of nADC was0.891 with sensitivity and specificity of 88.7 % & 80% respectively while ADC AUC is 0.603 with sensitivity and specificity of 72% & 72% respectively(p = 0.03), and F4 stage nADC AUC was0.879 for with sensitivity and specificity of 90% & 80% respectively ,while ADC AUC was 0.648 with sensitivity and specificity of 80 % & 72% respectively(p = 0.054)

Conclusion
Normalized liver ADC using the spleen as a reference organ increases the diagnostic performance of MRI in evaluation of liver fibrosis in comparison to ADC alone.
Role of susceptibility weighted imaging (SWI) in assessment of intra axial brain neoplasms in adults
Authors: Abo-Elhoda Pasant Mohamed Abo-Elhoda Darwish Mohamed , Mansour Hesham Mahmoud Ahmed , Abdullah Yosra Abdelzaher , Darwish Eman Ahmed Fouad 
Published: October 2021

Abstract

Background
Susceptibility weighted imaging (SWI) is a 3D gradient-echo MR technique that is based on blood oxygen level dependent (BOLD) induced phase effects between the venous blood and the surrounding brain parenchyma. SW-MR imaging allows for noninvasive visualization of small veins at submillimeter resolution and, therefore, is used to depict venous architecture in brain lesions. The extreme sensitivity of SWI for the detection of neovascularity (venous blood), haemorrhage, and calcification has been an indispensable tool for characterization of the internal architecture of brain tumours.

Objectives
Is to evaluate the role of Susceptibility weighted imaging in assessment of adults Intra axial brain Neoplasms, and its ability to characterize them into high and low grade lesions in comparison to histopathology which will be used as gold standard.

Methods
A cross sectional study including 31 patients suspecting intracranial brain neoplasm radiologically and clinically, conducted at Private center, the patients were investigated using Siemens machine Magnetom Skyra 3T, the period was between January 2018 till the end of June 2019 .

Results
Our study included 31 patients. Including 15 female and 16 male patients, with the patient’s age ranging from 20 to 68 years old with median 48 years old ranging from 35.75 (25% percentile) to 58.75 (75% percentile).
Among total cases, there were 8 patients with grade 2 glioma, 10 patients with grade 3 glioma and 6 patients with grade 4 glioma, 2 patients with lymphoma and 5 patients with brain metastasis (1 lung cancer and 4 breast cancer). All the patients were evaluated with MRI including SWI sequence with special comment on the number of the intratumoral susceptibility signal (ITSS), the size of the ITSS, its morphology as well as the ratio of the ITSS to the tumor size, which were then correlated with the patient histopathological results obtained later. The study revealed that the best parameter to accurately grade the tumor is the number of ITSS within the lesion with P value 0.001, followed by the size of the ITSS with P value 0.002 and Pearson Chi-Square value equals 20.6, while the lowest one was the ratio of the ITSS to the tumor size with P value 0.002 Pearson Chi-Square value equals 17.3. Our study showed that the morphology alone was not able to accurately grade the tumor with P value 0.007 ( Not significant)

Conclusion
SWI using 3T MR system provides quite useful information for preoperative tumor grading. There seems to be a strong correlation between pathological grading and that assessed with SWI.
Role of Laryngeal Ultrasonography in screening for laryngeal diseases in symptomatic patients
Authors: ElRayes Ramy Osama , Mansour Hesham Mahmoud , Hafez Nirvana GamalElDin , Nasr Merhan Ahmed 
Published: October 2021

Abstract

Background
Laryngoscopy is widely considered the most appropriate tool for evaluating the larynx, however, it is invasive and not all patients can tolerate it. Although laryngeal ultrasound has been proposed as a promising noninvasive technique that can play an important role in laryngeal imaging, there is lack of consensus regarding its role.

Objective
The aim of this study is to assess laryngeal ultrasound sensitivity compared to indirect laryngoscopy in screening for laryngeal diseases in symptomatic patients.

Patients and methods
30 undiagnosed symptomatic patients underwent laryngeal ultrasound and indirect laryngoscopy. Their results were compared.

Results
Technical success rate of laryngeal ultrasound was (83%). It showed overall sensitivity of (78.9%) in detecting organic laryngeal diseases with high sensitivity in detecting laryngeal masses, reinke’s edema, vocal cord cysts and polyps (100%), vocal cord palsy (83.3%), intermediate sensitivity for vocal cord nodules (66.7%), and poor sensitivity for laryngitis and non organic voice disorders (0%).

Conclusion
Laryngeal ultrasound is a useful non invasive imaging tool that can be used with acceptable sensitivity in detecting organic laryngeal diseases excluding laryngitis, hindered mainly by complete thyroid cartilage calcification in older males. Consequently we recommend its use as complementary to clinical examination and mirror laryngoscopy, or as an alternative to indirect laryngoscopy when required and in routine neck ultrasound exams when appropriate.
Neoadjuvant Chemotherapy for Breast Cancer: Evaluation by PET / CT
Authors: Maarouf Rania Ali , Abdel-Rahman Amgad S , Mohamed Samar Ibrahim 
Published: October 2021

Abstract

Background
Breast cancer (BC)is the most commonly occurring cancer in women and the second most common cancer overall.An increase in the rate of breast preservation has come to be expected because of tumor reduction using neo-adjuvant chemotherapy (NAC) for locally advanced cancer and it is important to accurately determine the effects of NAC.

Patients and Methods
This study was conducted on 30 female patients with histopathologically confirmed breast cancer referred for a PET/CT scan aiming to demonstrate the role of 18F-FDG PET/CT in detecting the pathological response to NAC in BC patients.

Results
No statistically significant differences were found between the baseline number of lesions and that after three cycles of chemotherapy. Also, no statistically significant differences were found between the mean values of baseline and after three cycles of chemotherapy of both liver activity and size of right breast lesions. Meanwhile, the mean values of SUV of right and left breast lesions as well as the size of left breast lesions were significantly lower after three cycles of chemotherapy when compared to their baseline values. And no statistically significant differences were found between complete and partial therapeutic response in the right breast lesions as well as between complete and no therapeutic response in the left breast lesions as regards baseline SUV and SUV after 3 cycles of chemotherapy.

Conclusion
It can be concluded that FDG-PET/CT is useful for evaluation of neo-adjuvant chemotherapy for breast cancer. However, more studies are needed to validate the results of the current study.