bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Outcome of Transforminal Lumbar Interbody Fusion and Posterolateral Lumbar Fusion with Instrumentation in Treatment of Degenerative Lumbar Disorders
Authors: Hemida Salah A , Saoud Khaled M , Sabry Hatem A , Abouelmaaty Emad M , Selim Fady K 
Published: October 2021

Abstract

Background
Degenerative lumbar disorders are relatively common condition that typically affects persons over the age of 50 and are more common in females. Patients typically present with a constellation of symptoms that include back pain, radiculopathy, and/or neurogenic claudication.

Aim of the Work
to assess the clinical and radiological outcome of Transforaminal Lumbar Interbody Fusion (TLIF) and posterolateral fusion (PLF) in the treatment of degenerative lumbar disorders.

Patients and Methods
a prospective study was conducted on patients with degenerative lumbar spondylolisthesis and degenerative lumbar spine stenosis who were admitted to Neurosurgical department at Ain Shams University hospital and Arab contractors medical center and underwent lumbar spine fixation with either transforaminal interbody fusion or posterolateral fusion from February 2017 to February 2019. The patients were divided into two groups according to the operative procedure done for each group. Group A (20 patients) included patients who underwent transforaminal lumbar interbody fusion. Group B (20 patients) included patients who underwent posterolateral fusion.

Results
We found that both TLIF and PLF provide improvement of disability and pain in patients with degenerative lumbar disorders. TLIF is superior to PLF with regard to achieving radiographic fusion. There is no strong evidence to support the use of TLIF over traditional PLF in treatment of degenerative lumbar disorders, especially with the increased material costs associated with interbody fusion.

Conclusion
both TLIF and PLF provide improvement of disability and pain in patients with degenerative lumbar disorders. TLIF is superior to PLF with regard to achieving radiographic fusion.
Evaluation of Functional Outcome Following Resection of Supratentorial Lesions at Eloquent Brain Areas
Authors: Al-Abyad Ashraf , Jalalod’din Hasan , Nosseir Mohamed , Ahmed Omar El Farouk , Alahwal Fathi 
Published: October 2021

Abstract

Objectives
Microsurgical management of intrinsic brain tumors aims to maximize the extent of resection and to minimize the postoperative morbidity. The purpose of this study is to evaluate the functional outcome following surgical excision of supratentorial lesions at eloquent brain areas such as language, motor and sensory cortex, regarding the extent of resection, the karnofsky performance scale, the neurological deficit and seizure control.

Methods
A prospective study of 25 patients aged 15-55 years, 15 females and 10 males underwent surgical excision of supra-tentorial lesions at eloquent brain, The Karnofsky Performance Score (KPS), seizure attacks and neurological deficits were analyzed before and after resection. Functional resection was implemented using preoperative functional magnetic resonance image (fMRI), intraoperative image guidance and electrophysiological monitoring under total intravenous anesthesia (TIVA) or awake craniotomy and the extent of resection was quantified postoperatively.

Results
Preoperative median KPS was 76.8%. It improved one year post-operatively to 89.2%. One patient died 3 weeks postoperatively due to neurological, cardiac and chest complications. The pathology report revealed recurrent metastatic adenocarcinoma GIII. Preoperatively, twenty-three patients had seizure attacks, 10 were controlled and 13 were uncontrolled on medication. Postoperatively seven patients were Engels classification IC and 17 patients were controlled on anti-epileptics (Engels classification ID). Preoperatively 19 patients had hemiparesis/ hemiplegia, while immediate (one week) postoperatively 13 patients improved, 8 patients experienced initial worsening of the preoperative deficits and 4 patients had the same deficit as preoperatively while at 1-year postoperatively, 24 patients improved. Gross total resection (&gt;95%) was achieved in 19 patients, subtotal resection (&gt;75%) in 4 patients and partial resection (&gt;65%) in 2 patients.

Conclusion
Functional resection is believed to be a key prognostic factor in supratentorial lesions at eloquent brain regarding improving of karnofsky performance scale, neurological outcome and seizure control.
Evaluation of Pure Endoscopic Endonasal Approach in Management of Giant Pituitary Adenoma
Authors: Gerges Mina M , Sabry Hatem , din Hasan Jalalod , Ghobashy Mohamed Ashraf , Schwartz Theodore H 
Published: October 2021

Abstract

Background
Giant pituitary adenoma represents one of the challenging tumor for neurosurgeons. Many microsurgical approaches in the past were used for its management. Recently and with evolution of the endoscopic equipment and instruments, extended endoscopic transsphenoidal approach become one of the preferable approaches for its surgical excision.

Methods
We prospectively document the clinical , surgical and follow up data for all patients presented with giant pituitary adenoma to Ain-Shams university hospital and Weill Cornell Medical College, Presbyterian hospital and were surgically treated with extended transsphenoidal approach from 2015 till 2019.

Results
Our group study formed of 44 patients with mean age 53.03 (range 14.7-82.4) and a male predominance (59%). The main presentation was visual problems in 75% followed by partial hypopituitarism in 31.81% while headache was in 13.64%. Only 4 patients had functioning adenoma (3 prolactinoma and 1 acromegaly). Average tumor volume was 26.95 ± 17.25 cm3, while the mean maximum tumor diameter was 4.73 cm (range 4.0-8.0 cm). Radiographic invasion was found in 97.73% to suprasellar cistern, 61.36% to the cavernous sinus and in 34% to the sphenoid sinus. GTR was achieved in 45.45% with Knosp score is the only significant predictor factor for resection rate (p = 0.04). Visual improvement achieved in 75.76%. 50% (2 patient) of the patients with functioning adenoma were cured. Complications included CSF leak in 3 patients, permanent DI in 4 patients and postoperative hematoma in 2 patients. Recurrence and progression rates without upfront radiation therapy were 5.00 % and 31.81% respectively after mean follow up period 57.90 months.

Conclusions
Extended endoscopic approaches for achieving maximum resection with minimal morbidity for giant pituitary adenoma are very effective. Lateral tumor extension with cavernous sinus invasion represents the limiting point in achieving gross total resection. Upfront radiation therapy for patients with residual adenoma can be avoided but regular follow up should be warranted.
A Comparative Study Between Preoperative Subconjunctival Bevacizumab Injection And Postoperative Topical Application In Prevention Of Recurrence After Excision Of Primary Pterygium In Egyptian Patients
Authors: Mohamed Basma Helal , Othman Ziko Othman Ali , Khairy Abd El Dayem Hisham M , Khamis Ahmed Nancy Ezzelregal 
Published: October 2021

Abstract

Purpose
to compare between recurrence incidence after primary pterygium excision when using preoperative subconjunctival injection of Bevacizumab (Avastin) and using it as a postoperative eye drops.

Methods
thirty two eyes of thirty patients (two patients had bilateral pterygium) with primary pterygia were clinically examined, classified into 3 groups and operated by simple excision with bare sclera technique. Group 1 included 10 patients received Bevacizumab (Avastin) in the form of eye drops (10 mg/ml) 3 times daily for 6 days postoperative. Group 2 included 10 patients received preoperative Bevacizumab in the form of subconjunctival injection (1.25 mg/0.05ml) single dose 1 week preoperative. Group 3 included 10 patients (12 eyes) 2 patients with bilateral Pterygium didn’t receive any form of Bevacizumab. Postoperative follow up was done clinically and by serial photography at 1 week, 1 month, 3 months and 6 months searching for signs of recurrence and/or complications.

Results
The results showed different grades of recurrence in 18 eyes of 32.True recurrence was seen in 7 patients of 18 (1 patient in group 1, 2 in group 2 and 4 in group3).Recurrence grades in group 1and 2 who used the Bevacizumab (20%grade II, 50% grade III, and 30% grade IV). Recurrence could be predicted by 100% depending on fibrovascular tissue appearing in the surgical bed at 3 months postoperative (P value 0.038).Preoperative fleshy pterygium has high statistical significance in realation to recurrence(P value = 0.006).Patient’s sex, residence and occupation had no statistically significant value in the process of recurrence (P value &gt; 0.05). Patients with recurrent Pterygia (in group 1&2) had statistically significant changes in the corneal K- readings at 3 months and 6 months.No significant difference in the limbal or central corneal thickness in the operated eye and the other eye (Pvalue &gt; 0.05).

Conclusion
Bevacizumab (Avastin) is a well tolerated drug with multiple drug delivery methods.The eye drops give better results than the subconjunctival injection.Appearance of fibrovascular tissue in the surgical bed at 3 months predict the recurrence by 100%. Preoperative fleshy pterygia will mostly recur again whatever Bevacizumab form was used .The corneal thickness by anterior segment OCT has no role in prediction or detection of early pterygium recurrence.
Corneal Densitometry Changes after Epithelium-Off Corneal Collagen Crosslinking
Authors: Abbas Karim N , Sayed Raafat A. El , Mostafa Mouamen M 
Published: October 2021

Abstract

Background
Keratoconus is a progressive non-inflammatory, degenerative disease that affects the integrity of the collagen matrix within the corneal stroma. Corneal cross-linking (CXL) has been described as the only modality in halting the disease progression over the past decade.

Aim of the Work
To compare the change in corneal densitometry before and 6 months after CXL using our unique protocol.

Patients and Methods
A prospective observational study was conducted on 30 eyes of 30 patients with progressive keratoconus. Epitheliumoff CXL was done with application of Riboflavin (VibeX RapidTM) for 6 minutes at a rate of 1 drop/ minute. UVA was delivered using the Avedro KXL machine (Avedro, Waltham, MA, USA) using the following parameters: 7.2 joules, 12 milli watt/ minute and 10 minutes of accelerated continuous UV delivery.

Results
Within the anterior (120 um) stromal layer, the concentric zones (0 to 2 mm) and (2 to 6 mm) showed a significant elevation of mean densitometry 6 months post-surgery (P = 0.020) and (P = 0.023) respectively compared to the baseline, However the concentric zones (6 to 10 mm) and (10 to 12 mm) showed a non-significant elevation of mean densitometry 6 months post-surgery (P = 0.167) and (P = 0.234) respectively compared to the baseline.

Conclusion
There is a significant increase in corneal densitometry 6 months postsurgery of the anterior stromal layer within the central 6 mm zone.
Evaluation of Fusion and Stereopsis in Anisometropic Patients
Authors: Ahmed Rana Mohamed , Noah Hazem Hosny , Zawahry Walid Mohamed El , Ismail Ahmed Taha 
Published: October 2021

Abstract

Background
Binocular vision has many important advantages on monocular vision as it helps in determination of the distance of an object, gives much greater depth of perception, and the ability to have stereopsis and view the world in three dimension (3D). There is an evidence that binocular vision is present in many patients with anisometropia even who have amblyopia but with grades lower than normal.

Purpose
This study evaluates the effect of anisometropia on BSV functions.

Method
sixty-four patients above 6 years with anisometropia equal to or more than 2.5D never had their vision corrected either by glasses or refractive surgeries or went on patching treatment, Anisometropic patients were devided into two groups amblyopic group (AA) and non-amblyopic group (NA) were examined for assessing their fusion by Worth four dot test and their stereopsis by fly test (Titmus stereo acuity test) by their best corrective glasses based on their cycloplegic refraction.

Results
Anisomyopes shows better stereopsis 62% of them and better fusion 65% of them than anisohypropes which had only 8% with good stereopsis and 32% with good fusion. However, antimetropes showed bad fusion and stereopsis as all of the five cases have amblyopia. Only 29.5% of anisomyopes have amblyopia but 68% of anisohypropes have amblyopia. As regard worth four dot test (P &lt; 0.001), as 90.6% of cases with amblyopia had suppressed eye but only 9.4 % of this amblyopic cases had normal fusion. However, in patients without amblyopia 15.6% had suppressed eyes but 84.4% had normal fusion. As regard Titmus test there was statistically significant difference between both groups (P &lt; 0.001), as 100 % of cases with amblyopia had bad stereo acuity but 28.1% of patients without amblyopia had defect in their stereo acuity.

Conclusion
Fusion and stereopsis as binocular single vision functions were significantly affected in AA patients with best-corrected anisometropic glasses than in NA patients.
Comparison between different techniques for management of renal stones in horseshoe kidneys
Authors: Aggour Abdel Fattah Mohammed , Tolba Mohamed Kotb Ahmed , hatata Abdelrahman nazmy abbas 
Published: October 2021

Abstract

Objective
To report the operative management , intra and post operative complications and subsequent stone-free rates of patients with urolithiasis in a horseshoe kidneys.

Materials and Methods
We retrospectively reviewed all patients presenting to our centre with a horseshoe kidney and urolithiasis over a 20-year period. The stone burden, surgical management, complications and stone clearance rates were recorded.

Results
In all, 80 patients with urolithiasis in horseshoe kidney were treated. Percutaneous nephrolithotomy (PCNL) was used in 28 patients. 12 patients had laparoscopic assisted PCNL , 8 had flexible ureteroscopy and 18 had laparoscopic pyelolithotomy . PCNL was used for large stones = (mean digitized surface area= 614.32 mm 2 ) and required one to four stages to achieve an overall stone clearance rate of 88%. Stones were cleared at one sitting in 77% of PCNL procedures. only 33% of patients treated with flexible ureteroscopy was cleared from stones in one session and surprisingly, 89% of patients treated with laparoscopic pyelolithotomy was stone free after one session Complications were minimal, with 15% minor and 3% major complications in the PCNL group only..

Conclusions
Appropriate management of urolithiasis within the horseshoe kidney depends not only on stone burden, but also on stone location, calyceal configuration and malrotation. Stones can be cleared successfully in almost all patients providing that all techniques are available to the operating surgeon.
Short-term surgical outcomes after Monopolar- versus Bipolar Transurethral Resection of the Prostate
Authors: Ramadan Ahmed , shoeb mohammed , Shabayek Mohamed 
Published: October 2021

Abstract

Background
Transurethral resection of prostate (TURP) is currently the gold standard for surgical treatment of benign prostatic hyperplasia (BPH), as this procedure results in the best improvement in symptoms and urine flow rate (1).

Aim of the Work
to compare between the two techniques used for transurethral resection of the prostate; Monopolar versus Bipolar resection as regards short term surgical outcomes, perioperative complications and early changes in quality of life..

Patients and Methods
Randomized controlled study with simple randomization (1:1) of 80 patients with BPH candidate for transurethral resection of the prostate, 40 patients underwent M-TURP, and other 40 patients underwent B-TURP, their age mean age of paients included in our study 57-61 years old, mean prostate size 68-71 gm.

Results
Comparing intra-operative data in monopolar and bipolar TURP groups, our study reported that there was statistically significant decrease in volume of irrigation and operative time in B-TURP group in comparison to M-TURP group. although intra-operative complications; bleeding, electrolytes disturbance, fever and LUTS were lower in BTURP group; however, did not reach statistically significant.
In M-TURP group ,there was statistically significance increase in change Hb, and time of post-oprative irrigation, IPSS in compared to B-TURP group. While in respect to PVR, time of catheterization and hospital stay, there was no statistically significant difference data among the two studied groups.

Conclusion
Bipolar TURP represents a promising endoscopic treatment for patients with BPH with decrease in volume of irrigation and reduced operative time, and less incidence of TUR syndrome, intraoperative bleeding, and postoperative complications .However, further investigations are needed with larger, preferably randomized multicentric controlled trials to confirm the results of this study in the future.
Evaluation of Galdakao-modified Valdivia Position in Combined Simultaneous Access to Upper and Lower Urinary Tract Pathologies
Authors: Abdelmotagely Yehia Hesham Mohamed Zaky , El Moneim Abu El Naga Mohamed Abd , Gad Hany Hamed , Maged Wael Ali 
Published: October 2021

Abstract

Background
Simultaneous retrograde and antegrade endoscopic combined intrarenal surgery in modified supine lithotomy positions offer significant progress in the endoscopic management of urolithiasis. The operative time has been significantly reduced.

Aim of the Work
To evaluate the Galdakao-modified Valdivia position in simultaneous handling of upper and lower urological pathologies in the same units.

Patients and Methods
The evaluation for the Galdakao-modified Valdivia position regarding the benefits in different upper and lower urological diseases was the aim of our prospective randomized clinical trial that will started on April 2017 and ended by April 2019.

Results
The study has included 60 patients comprising males and females.

Conclusion
We believe that GMSV provided a great versatility in the treatment for urolithiasis along the whole urinary tract, ante-retrograde access, treatment of uretero-ileal strictures in patients with urinary diversions or neobladders, missed double j stent, bilharizoma of the ureter and bladder mass involving the ureteric orifice. Also, the advantage provided by this approach to the surgeon, patient and anesthetist may lead to widespread adaptability of this technique in the management of complex urolithiasis.
A Study of Iron Status in Pediatric Patients with large complex Vascular Malfomations
Authors: Ellaboudy Mohamed Abdel-Mohsen , Ragab Iman A , Abo-Zeid Amr Abdel Hamid , Ali Heba G.A , Ahmed AliaaMourad 
Published: October 2021

Abstract

Background
Complex vascular malformations involving the gastrointestinal tract (GIT) are expected to develop iron deficiency.However, the haemoglobin and iron status of vascular anomalies unrelated to GIT were not addressed.

Our aim
was to study the frequency of anemia and iron status among pediatric patients with large/complex vascular malformations without evident bleeding and to correlate the findings with the type, site, severity and extension of vascular malformationand treatment with sirolimus.

Patients and method
A case control study of participants with large complex vascular malformationregistered at Ain Shams University vascular anomalies clinic during the period from June 2019 to June 2020.They were compared to 20 age, sex and socioeconomic standard matched healthy controls. Clinical and laboratory studies for iron status were performed.

Results
fifty percentof patients were anemic versus 65% of the control group (p value = 0.33).As regards iron status of patients, 35% has combined iron deficiency versus 40% of controls, 20% has functional iron deficiency versus 20% of controls, 5% has absolute iron deficiency versus 10% of controls (p value = 0.90). There was no significant difference between patients receivingsirolimus and who are not as regards anemia and iron status (p value = 0.36, 0.84, respectively).

Conclusion
The frequency of anemia and it s iron related classification are comparable in children with large vascular malformations with no bleeding manifestations to normal children.
Estimation of Intestinal Fatty Acid Binding Protein Level as a Marker of Gut Failure in Critically ILL Pediatric Patients
Authors: Ibrahim Hanan M , Hermina Christina E , Magdy Sondos M 
Published: October 2021

Abstract

Background
Sepsis is a life-threatening condition and frequently associated with gut failure manifestations. Gut failure was defined as a rapid reduction of smallbowel enterocytic function. Gut barrier function has been studied using serum IFABP level as a marker of functional enterocytic mass.

Objective
To estimate the serum IFABP level in septic pediatric cases associated with gut failure.

Patients and Methods
This cross-sectional study was conducted on 40 Egyptian children admitted to Pediatric Intensive Care Units (PICUs) of Ain Shams University Hospitals. Serum IFABP level was measured in plasma using enzyme-linked immunosorbent assay (ELISA). All critically ill septic patients diagnosed with acute gut failure admitted in the period from 1/4/2018 to 1/5/2019 were subjected to serum IFABP level measurement at the first and the tenth day of diagnosis.

Results
The serum IFABP median levels on day one and day ten were higher in patients group (5.08 µmol/ml - 9.34 µmol/ml) than control group (0 1.7 µmol/ml – 1.7 µmol/ml) with p value 0.014, 0.020 respectively. Also it was higher in survivors group (17.78 µmol/ml) than non survivors group (3.39µmol/ml) with p value 0.047. SOFA score was lower in survivors (5) than non survivors (8) with p value 0.020.

Conclusion
IFABP serum level can be a promising marker to detect early intestinal wall and enterocyte damage, taking into consideration time of sampling and inotropes administration.
Unfractionated Heparin (UFH) For Prevention of Central Venous Catheter Thrombotic Complications in Children: A systematic review and meta-analysis
Authors: Nasef Marwa W , El-gaffary Maha M , Mansour Mervet G , Abd El Aty Esraa S 
Published: October 2021

Abstract

Objective
To determine the efficacy of unfractionated heparin in reducing central venous catheter-related deep venous thrombosis and/or catheter thrombotic occlusion in children by systematically searching the literature and conducting a meta-analysis study.

Methods
Four electronic databases (PubMed, Google Scholar, Elsevier’s thrombosis journal, and the Cochrane Central Register for Controlled Trials) were searched for journal peer-reviewed articles published in the period from Jan 2000 to Dec 2018. The search criteria included observational studies, and randomized controlled trials on patients aged 0–18 years with central venous catheters (CVC), which compare between the effect of UFH (flushes, lock solutions, continuous infusion, and heparin bonded catheter) and no prophylaxis (Normal saline flush or no treatment) for the prevention of CVC thrombotic complications (CVC-related deep venous thrombosis (DVT) and/or catheter thrombotic occlusion). Two authors independently reviewed and identified the eligible studies, which were assessed for study methodology including bias, and extraction of unadjusted data whenever available. To pool data from eligible studies, the meta-analysis was performed on RevMan version 5.3. Odds ratios were generated with the corresponding 95% CI through the random-effect model.

Results
Of the 413 articles identified, only eight studies were eligible with 1380 patients. Our results revealed that UFH was significantly superior on control group in reducing thrombotic occlusion and/or CVC-related DVT (odds ratio 0.39, 95% CI: 0.19:0.8) (p 0.01).

Conclusion
The published data support the hypothesis that using UFH as a thromboprophylaxis may significantly reduce catheter thrombotic complication in pediatric patients with CVC.