bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological and Biochemical Factors (Serum Ferritin and Vitamin D) Associated with Premature Graying Of Hair
Authors: taher Alrgig Nawres , Samy Abdel Fattah Nermeen , Mahmoud Elhusseiny Rania 
Published: October 2021

Abstract

Background
Premature graying of hair (PHG) is defined as graying of hair before the age of 20 years in Caucasians and before 30 years in Blacks. Several factors contribute to development of hair graying as genetics, environmental factors, life style and stressful events. Also, many biological markers were associated with development of hair graying as vitamin D, ferritin, vitamin B12 and many other electrolytes as calcium and magnesium.

Aim of the study
assess various epidemiological factors and biochemical variables (serum ferritin and vitamin D) associated with premature graying of hair.

Patients and methods
The current study included 75 premature hair graying patients, and 75 apparently healthy controls of matched age and sex. Assessment of epidemiological, clinical characteristics, estimation of serum levels of vitamin D and ferritin was done for included subjects.

Results
We detected positive correlation of sedentary life style, stress perception and family history with PHG development. No significant difference of vitamin D between the two groups, while low serum ferritin was significantly associated with PHG patients.
Study of The Relationship Between Psoriasis of Different Clinical Varieties and Osteoporosis
Authors: El Sayed Mahira Hamdy , El Husseiny Rania Mahmoud , Al Saadi Omar Adnan Hoom 
Published: October 2021

Abstract

Background
Psoriasis is considered as a systemic disease since it is an inflammatory skin disorder associated with increased level of many inflammatory cytokines, which can result in many comorbidities. It was hypothesized that there is an association between psoriasis and osteoporosis and many studies investigated this association, but the majority of them focused on the association between psoriatic arthritis and osteoporosis, while this study excluded psoriatic arthritis and investigated the association between psoriasis of different clinical varieties and osteoporosis.

Objective
to assess the associated relationship between psoriasis and osteoporosis in psoriatic patients of different clinical varieties, by measuring the prevalence of osteoporosis in a sample of these patients.

Subjects and methods
Our cross-sectional study included 42 psoriatic male and female patients with non specific ages, 48% of them were males (20 patients) and 52% of them were females (22 patients), and it excluded any patients with endocrinal disorders, chronic renal failure, liver cell failure, other chronic inflammatory disoredres, malabsorption, history of alcohol misuse, history of intake of steroids for longer than 6 months, pregnant women and psoriatic arthritis. All patients were subjected to a questionnaire for detailed history taking, complete general and dermatological examinations, evaluation of psoriasis severity by Psoriasis Area and Severity Index (PASI) score and bone mineral density (BMD) measurement using the DEXA method of the lumbar spine (L1L4) and femoral neck.

Results
The prevalence of osteoporosis among psoriatic patients was (9.5%), (10%) in males and (9%) in females, which was lower than the prevalence of osteoporosis in the population. While the prevalence of osteopenia was 50%, (45%) in males and (54.5%) in females, which was higher than the prevalence of osteopenia in the population. Additionally this study showed a statistically significant negative correlation between the age of the patients and BMD, and a highly significant positive correlation between the BMI of the patients and BMD, while there were non significant negative correlations between both (duration of psoriasis and PASI score) and BMD, and no significant correlations between clinical variants of psoriasis and BMD.

Conclusion
Psoriasis is associated with a decrease in the bone mineral density more in males, with higher incidence of osteopenia rather than osteoporosis. The decrease in BMD increases with increasing age, duration of psoriasis and PASI score, decreases with increasing BMI, while the clinical variants of psoriasis didn’t seem to affect the BMD of psoriatic patients.
Efficacy of Fractional Co2 Laser and Human Lyophilized Growth Factors in the Treatment of Stretch Marks: A Clinical and Histopathological Study
Authors: Abdallah Mahmoud Abdel Reheem , Mostafa Azza Esmat , Abdel Hameed Mohammad Shawkat Mohammad 
Published: October 2021

Abstract

Background
Striae distensae are a well-recognized, common skin condition that rarely causes any significant medical problems but are often a significant source of distress to those affected. The natural evolution of striae is from red or purple, raised wavy lesions (striae rubra) to white atrophic lesions with wrinkly surface (striae alba).

Objectives
The present study was designed to compare the efficacy of fractional CO2 laser alone or combined with lyophilized growth factors or to its efficacy alone in the treatment of striae distensae.

Patients and Methods
The present study included 20 female patients with SD; they were all recruited from Dermatology Outpatient Clinic, Ain Shams University from may 2017 to march 2018. An informed consent for treatment, photography and punch biopsy was taken before enrollment and the study was approved by Dermatology Research Ethical Committee.

Results
The present study showed statistically significant clinical and histopathological improvement in areas A and B after treatment. This impronment was in rubra more than alba. Area C showed no clinical and histopathological improvement. Area B showed better results than area A.We propose that LGF alone did not show clinical or histopathologiacl improvement. Treatment was tolerated well by all patients where side effects were minimal in the form of transient PIH that resolved after using bleaching creams. There was no statistically sgnificant difference in the incidence of PIH between areas A& B.

Conclusion
We concluded that fractional CO2 alone is effective in treatment of SD especially stria rubra in skin type III and IV.
Role of intratympanic steroid injection in treatment of otitis media with effusion: A systematic review/ Meta -Analysis
Authors: Mohammed Ahmed A , Hamdy Tarek A , Askoura Anas M , Abdulhakim Ahmed M 
Published: October 2021

Abstract

Background
Otitis media with effusion (OME) is a worldwide major health problem for both children and adult, who have a history of chronic eustachian tube dysfunction.

Aim of the Work
to review the effect of intratympanic injection of steroids in treatment of chronic otitis media with effusion (persistent more than 3 months after failure to medical treatment [e.g. local & systemic steroids or decongestants] or surgical ventilation tubes).

Material and Methods
This systematic review was done as a collective analysis of 5 retrospective and prospective cohort studies done on patients with OME. Studies on Patients who were diagnosed with chronic otitis media with effusion not responding to conventional methods of treatment.

Results
The data analysed and results showed an improvement of 41.2% of the cases treated with intratympanic injection of steroids compared to 11% improvement in cases treated by conventional medical methods with a relative improvement around 6.4 folds to intratympanic injection of steroids over medical treatment. All of these studies have shown that there are more advantages of directed ototopical steroid therapy over systemic therapy. Topical medications often have limited systemic effects due to their limited systemic uptake. It may be less expensive as compared to systemic medications.

Conclusion
Intratympanic injection of long acting steroids has good effect in management of OME resistant to medical and surgical treatment and has superior effect and high rate of recovery on local nasal steroid spray. In children combination of ventilation tubes and intratymapnic injection of steroids is the best known modality of treatment. Further studies are needed to evaluate the best medical treatment of chronic OME.
SYSTEMATIC REVIEW AND META-ANALYSIS OF THE PALATAL SURGERIES IN THE TREATMENT OF OBSTRUCTIVE SLEEP APNEA
Authors: Rabie Amr Nabil , Mady Ossama , El-Shazly Ahmed Negm , Abouzeid Alaa 
Published: October 2021

Abstract

Background
The first description of a patient with obstructive sleep apnea was in ‘The Posthumous Papers of the Pickwick Club’ published by English writer Charles Dickens in 18361. The first introduction of the terms ‘sleep apnea syndrome’ and ‘obstructive sleep apnea syndrome’ was by Guilleminault et al in 1967. Subsequently, Guilleminault coined the term ‘upper airway resistance syndrome’ in 19932.

Objectives
This paper aims to examine published articles between January 2008 and January 2019 on the different palatal surgeries performed on OSA patients and the treatment outcomes, which in turn will be used to determine two things. The first being the effectiveness of various palatal surgical techniques in treating OSAS and the second (if applicable) the most effective of the palatal surgical techniques in treating OSAS.

Patients and Methods
The current review followed the guidelines of preferred reporting items for systematic reviews and meta-analysis statement 2009 (PRISMA)5. The detailed steps of methods were described elsewhere as well as PRISMA checklist. The quality of relevant studies was assessed using NIH quality assessment tool for observational cohort and cross -sectional studies as well as NIH tool for quality assessment for case series studies.

Results
Meta-analyses of relevant studies showed that the surgical technique that achieved the best reduction on AHI was the lateral pharyngoplasty followed by the Anterior Palatoplasty, with a significant mean reduction of [(SMD= -0.848, 95% CI (-1.209 – -0.487), p-value&lt;0.001) and (SMD= -0.864, 95% CI (-1.234 – -0.494), p-value&lt;0.001), respectively]. The technique responsible for the best improvement in ESS was the Relocation Pharyngoplasty, with a significant mean reduction of [SMD= -0.998, 95% CI (-1.253 – -0.743), p-value&lt;0.001]. Minimal O2 saturation level improved most with the Expansion Sphincter Pharyngoplasty, with a significant mean reduction of [SMD= 1.011, 95% CI (0.581 – 1.440), p-value&lt;0.001]. The surgical procedure that result in the best post-operative VAS was Z-Palatoplasty, with a significant mean reduction of [SMD= -1. 551, 95% CI (-2.049 – -1.052), p-value&lt;0.001]. soft palate length change with a significant mean reduction of [SMD= -2.219, 95% CI (-2.730 – 1.708), p-value&lt;0.001]. Finally, meta-analyses of relevant studies showed that expansion sphincter pharyngoplasty achieved the overall highest success rate [Event rate= 77%, 95% CI (65.4%– 85.5%), p-value&lt;0.001]

Conclusion
The best procedure for treating OSA varies from patient to patient and there is no universal cure-all. Careful patient selection and pre-operative evaluation are mandatory.
Endoscopic Coblation versus Cold Curettage Adenoidectomy
Authors: Rabie Amr Nabil , Mohammed Mohammed Abdelaleem , Ibrahim Amany Farid Saad 
Published: October 2021

Abstract

Background
Adenoidectomy remains one of the surgical procedures most frequently performed by otolaryngologist. Adenoid hypertrophy causes nasal obstruction and airway problems such as snoring, obstructive sleep apnea, recurrent sinusitis, and/or Eustachian tube dysfunction. There is also reduced ability to smell and taste, hyponasal speech and craniofacial abnormalities. These complications frequently lead to a need for adenoidectomy.

Aim of the Work
Compare between endoscopic coblation versus cold curettage adenoidectomy as regard operative time, blood loss, post-operative pain and complications.

Materials and Methods
We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists.

Results
We performed a comperehensive search of five electronic databases to comperehensively include all eligible studies. In addition, the risk of bias was low among the included studies. However, we acknowledge that the present study has some limitations. Some included studies were observational studies with inherent limitations of possible misclassification and ascertainment bias. In addition, most of the studies were a single-center experience and therefore the results cannot be generalized to the general population.

Conclusion
Endoscopic coblation technique is superior to cold curettage adenoidectomy in pediatric population. The present systematic review and meta-analysis showed that endoscopic coblation technique had better outcomes in terms of intraoperative blood loss and postoperative pain. However, special attention should be paid for operation time with endoscopic coblation. Nevertheless, further studies are still needed to confirm our findings and to identify patient factors that significantly increase the rate of recurrence in both techniques.
The Impact of the Age at the Cochlear Implantation on the Pragmatic Development of the Prelingual Hearing Impaired Egyptian Arabic Speaking Children
Authors: Moussa Dina Fouad El Sayed , Shoeib Rasha Mohammed , Mona Sameeh Khodeir 
Published: October 2021

Abstract

Background
Hearing impaired children have delayed development of pragmatic skills as hearing impairment (HI) deprives them from exposure to natural communication interactions. The rehabilitation of children with HI aims to improve their listening skills for better language development and better communication and social interactions.

Aim of this work
to compare the pragmatic language development of the prelingual hearing impaired children who were cochlearly implanted before the age of 3 years and those who were cochlearly implanted after the age of 3 years.

Methods
Sixty Egyptian Arabic-speaking children with prelingual severe to profound sensory neural hearing loss, thirty children who were cochlearly implanted before the age of 3.0 years compared to thirty children who were cochlearly implanted after the age of 3.0 years. Language assessment was done by Modified Preschool Language Scale – 4th edition (PLS–4), the Arabic version and pragmatic development was assessed by Standardized Egyptian Arabic Pragmatic Language Test (EAPLT).

Results
The two study groups showed no significant differences regarding the receptive, expressive, and total language test scores by PLS-4. Group I showed a significant difference (improvement) regarding the pragmatic factors while there were no significant differences between the two study groups regarding the rest of the pragmatics scores by EAPLT.

Conclusion
The pragmatic language of cochlearly implanted children either who have been implanted before or after 3 years old is affected. This higher susceptibility to pragmatic impairment in prelingual cochlearly implanted children, as well as the importance of pragmatic skills for further social-communicative and academic careers, should be considered in their rehabilitative plan and advocate the importance for early incorporation of pragmatic behaviors into their intervention programs.
Construction of a Therapy program targeting Expressive language in non verbal autistic children
Authors: EL-Sady Safaa R , Shadi Mariam S , Rezk Marwa G 
Published: October 2021

Abstract

Background
Some autistic children remain non verbal even after receiving multiple interventions. There is no obvious cause can explain failure of those autistic children who have adequate cognitive ability and communicative intent to acquire spoken language, except childhood apraxia of speech (CAS) that is treated differently than autism. Little is written about specific therapy programs that apply CAS treatment strategies to promote speech production for non verbal autistic children.

Purpose
The aim of this work is to detect the effectiveness of a therapy program targeting expressive language for non verbal autistic children by applying CAS treatment strategies.

Methods
pre – post single subject design in which each child acts as his or her own control. All the twenty children included in the study had been received previous language therapy at least for 6 months before the starting of the study with no improvement in verbal output.

Results
Of the twenty children enrolled in this study, eighteen children developed spoken language at least multiple single words used both during therapy session and at home.

Conclusion
a structured conversational language therapy program that apply CAS treatment strategies can help non verbal autistic children to acquire expressive language.
Use of Co2 Laser versus conventional microlaryngeal surgery in treatment of vocal fold benign lesions
Authors: El-Halaby Hesham , El-Begermy Marwa M , Hakim Mina Zakaria 
Published: October 2021

Abstract

Background
Benign superficial lesions of vocal fold (nodule, polyp, cyst and Reinke's edema) arise from the epithelium and the lamina propria. Vocal abuse and misuse presumably lead to excessive mechanical stress and trauma in the membranous portion of vocal fold, resulting in wound formation. Wound healing leads to remodeling of the superficial layer of the lamina propria. This tissue remodeling leads to formation of benign vocal fold lesions. These lesions are classically treated by conventional microsurgery and recently by CO2 laser. The use of the CO2 laser for the surgical treatment of Minor Associated Pathological Lesions (MAPL's) is still controversial. Some preferred cold instruments, whereas others appreciate CO2 laser as a novel alternative to conventional microsurgery for benign vocal fold lesions. To summarize the reviewed literature the issue of CO2 laser versus cold instruments is still controversial and the stage is open for more studies.

Aim
The aim of this study is to investigate the effect of Co2 Laser versus cold instruments in the treatment of benign lesions of the vocal folds regarding voice outcome & vocal fold function.

Methodology
A meta-analysis study is done to assess the use of Co2 Laser versus conventional microlaryngeal surgery in treatment of vocal fold benign lesions.

Results
This study does not reveal any detectable differences in clinical outcomes in patients with nodules, polyps and cysts who underwent excision via CO2 laser or cold instruments.

Conclusion
There is no sufficient evidence to determine if conventional surgery or CO2 assisted surgery is better.
Prevalence and predictive factors for exclusive breastfeeding in the first 6 months among mothers attending Primary Health Care Centers in Cairo, Egypt
Authors: Emara Zeinab Abdelhay , Amin Ghada Essam Aldin , Hamid Diaa Marzouk Abdel , Allam Mohamed Farouk 
Published: October 2021

Abstract

Background
Although most organizations recommend breastfeeding for at least one year due to its well-known beneficial effects, the prevalence of exclusive breastfeeding in many developing countries was quite low and the current prevalence of breastfeeding and predictive factors for its discontinuation are not well-known.

Objectives
To identify prevalence and predictive factors affecting exclusive breastfeeding in Primary Healthcare (PHC) Centers in Cairo, Egypt.

Methodology
A cross sectional study, among mothers attended first six months immunization sessions in three PHC Centers were selected via a convenient sample, A total sample of 180 mothers, 60 from each PHC Center, accepted to participate in our study and were subjected to an interview questionnaire. The questionnaire used was previously validated and pre-tested. Data collection took the period from April to August 2019. Comparison between exclusive and nonexclusive breastfeeding according to possible risk factors was done.

Results
The frequency of breastfeeding among the participants was 90.6%; however the total (0-6 months) exclusive breastfeeding frequency was only 39.4%. Our logistic regression model showed that exclusive breastfeeding decreased with progressive increase in infant’s age with OR of 0.74, and mothers with good knowledge about proper practice of breastfeeding (e.g. infant’s chin should be immersed in mother's breast and most nipple halo in the infant lower lip) adhered more to exclusive breastfeeding with OR of 2.51. Also, it showed that, during working hours, mothers who fed their infants other than breast milk adhered less to exclusive breastfeeding with OR of 0.19.

Conclusions
The prevalence of exclusive breastfeeding is quite low, a problem seen in most of developing countries. The predictive factors for exclusive breastfeeding are, younger infant’s age, good knowledge of the mothers about proper practice of breastfeeding, and mothers insisting on breastfeeding during working hours.
Surgical Site Infections; A Study of Incidence, Risk Factors and Causative Organisms in Emergency Abdominal Surgeries
Authors: Omran Hisham , Elmageed Shaaban Mohamed Abd , Arab Ahmad Gamal Abu , Saeed Mohamed Hesham 
Published: October 2021

Abstract

Background
Surgical site infection (SSI) is the most commonly reported nosocomial infection. Surgical site infections are responsible for increase in cost, morbidity, and mortality related to surgical operations. Surveillance with information feedback to surgeons and other medical staff has been shown to be an important element in the overall strategy to reduce the numbers of SSIs.

Objectives
To determine the incidence and factors responsible for, causative micro-organisms and effective antibiotics for surgical site infections following emergency abdominal operations.

Patients and methods
a total of 252 patients were enrolled in the current study and were retrospectively followed till the tenth day post-operatively. Data collection sheets were filled in for all the patients. If any symptom or sign of infection appear during this period then proper investigation was instituted for the diagnosis of infection and to assess the type and severity of the infection. If any collection of pus identified it was drained out and sent for culture and sensitivity test. Proper antibiotic was given to every patient both preoperative and post-operative periods. Antibiotic was changed where necessary after getting the report of culture and sensitivity test.

Results
Surveillance of SSIs in the current study revealed an SSI incidence of 21.4%. The most frequent organisms detected by wound swab cultures were E. coli (55.5%), followed by Klebsiella and coagulase negative staphylococci, with the emergence of resistant strains like MDR, AMPC, ESBL strains. Sensitivity to antiobiotics showed Colistin, Polymyxin B, Vancomycin and Tigecycline to be fully functional, next in sensitivity was piperacillin tazobactam, then meropenem, followed by imipenem and amikacin. SSI was found to be increased with the advancement in age, Smoking cigarettes and HCV positive cases. The fourth post-operative day was the commonest day for the occurrence of SSI with discharge from the wound being the most prevalent sign.

Conclusion
A surveillance system for SSI with feedback of appropriate data to surgeons and hospital authorities is highly recommended to reduce the SSI rate General Surgical Departments at Ain Shams Specialized Hospital - Police Hospital and other Departments as well.