bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metformin with standard neoadjuvant chemotherapy in breast carcinoma
Authors: Azazy Hend Ayman , Gado Nivine Mahmoud , Salem Dina Ahmed , El-Ghamry. Wesam Reda 
Published: October 2021

Abstract

Background
Breast cancer is the most common cancer among women which increases after the age of 35 till it reaches a peak at 55-64 years.
Metformin is a synthetic oral biguanide that has been shown to cause a 30% reduction in the lifetime risk of all cancers in diabetic patients on Metformin. We aimed at evaluating this antineoplastic effect in terms of pathological response, concurrent with standard neoadjuvant chemotherapy in breast cancer.

Methodology
60 non-diabetic breast cancer patients receiving standard neoadjuvant chemotherapy at the breast cancer outpatient clinic, Ain Shams University hospital, were randomized into two arms (30 in each arm);

Arm A
Group receiving Metformin (850 mg bid) with standard line of neoadjuvant chemotherapy (FEC/Taxotere +/- Herceptin).

Arm B
Control group receiving the standard line of neoadjuvant chemotherapy alone.

Results
There’s a significant difference between Metformin and control arm in terms of response (complete and partial) versus no response (p = 0.03). Response to Metformin was significantly more pronounced in Luminal B subtype breast cancer (p = 0.03) and in grade II (p = 0.03). There’s no significant difference in toxicity between both arms; most common toxicities in both arms were vomiting (53.6%), nausea (30.4%) and neutropenia (30.4%)

Conclusion
Metformin has a significant antineoplastic effect which was measured in this study in terms of significant increase in pathological response concurrently with neoadjuvant chemotherapy in breast cancer compared to giving neoadjuvant chemotherapy alone.
Survival outcome and treatment tolerability for postmenopausal females with early stage hormone receptor positive breast cancer treated with different adjuvant hormonal lines (TAM vs. AI vs. switching strategy) for 5 years
Authors: Riyad Atef Youssef , Elkhodary Dalia Abdelghany , Elghamry Wesam Reda Farag , Zaki Islam Abdelrahman Kamel Mohamed 
Published: October 2021

Abstract

Background
The standard adjuvant endocrine treatment for postmenopausal female patients with hormone receptor positive early breast cancer was 5 years of tamoxifen, but recurrence and side effects restrict its usefulness. The aromatase inhibitor (anastrozole or exemestane or letrozole) was compared with tamoxifen for 5 years or started after completing 2-3 years of tamoxifen in postmenopausal female patients diagnosed with early breast cancer at "Ain Shams University Hospitals"

Objective
The aim of the study was to measure survival outcome and treatment tolerability for postmenopausal females with Hormone Receptor Positive early breast cancer who received adjuvant hormonal treatment with tamoxifen [TAM] only for 5 years versus those who received adjuvant hormonal treatment with tamoxifen [TAM] for 2 years switching to aromatase inhibitors [AI] in the sequential 3 years versus those who received adjuvant hormonal treatment with aromatase inhibitors [AI] solely for 5 years.

Patients and methods
This study included 100 postmenopausal women with early breast cancer who presented at the Clinical Oncology Department, Ain Shams University, in the interval from January 2010 until December 2015.

Conclusion
Similar disease free survival and overall survival were observed among the three studied groups. Switching tamoxifen to aromatase inhibitors provides better tolerability in terms of endometrial thickness when compared to 5 years of tamoxifen monotherapy. Patients who administer aromatase inhibitor included in the switching strategy experience less osteoporosis and less generalized bone pain compared to upfront aromatase inhibitor to 5 years. There was a significant improvement of disease free survival (DFS) in human epidermal growth factor receptor 2 (HER 2) negative patients receiving any adjuvant hormonal treatment line for five years in comparison to HER 2 positive patients receiving the same adjuvant hormonal treatment for five years.
Distal Intra Articular Tibial Fracture Treated by Ilizarov with Ligamentotaxis
Authors: Fayd Mahmoud Mohamed , Al-Kersh Mohamed Ahmad , Bishay Elia Saad Fakhry 
Published: October 2021

Abstract

Background
The thin soft tissue and muscles envelope that surrounds the distal tibia makes treatment of these fractures difficult. These fractures are often referred to as ―pilon‖ fractures or ―plafond‖ fractures‖. If the articular surface of the tibia is involved; in such cases an anatomic realignment of the involved articular fracture in conjunction with a stable fixation is crucial.

Objectives
The aim of this paper is to conduct a systematic review of literature about functional and radiological outcomes in patients with distal intra articular tibial fracture treated by external fixator with ligamentotaxis.

Materials and Methods
We performed this systematic review and meta-analysis in accordance to the recommendations of the Meta-analysis of Observational Studies in Epidemiology (MOOSE) statement. MOOSE is a reporting checklist 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
Over all, five studies reported the time to union. The overall effect estimates showed that the time to union after Ilizarov external fixator was 12.83 weeks. Three studies reported the rate of union. The overall effect estimates showed that the rate of union after Ilizarov external fixator was 88.4%. Over all, eight studies reported the good-excellent AOFS score. The overall effect estimates showed that the rate of good-excellent AOFS score after Ilizarov external fixator was 69.4%. Nine studies reported the rate of malunion. The overall effect estimates showed that the rate of malunion after Ilizarov external fixator was 10.2%. Over all, seven studies reported the rate of delayed union. The overall effect estimates showed that the rate of delayed union after Ilizarov external fixator was 6.3%. All studies reported the rate of pin infection. The overall effect estimates showed that the rate of pin infection after Ilizarov external fixator was 33.7%. Ten studies reported the rate of major infection. The overall effect estimates showed that the rate of major infection after Ilizarov external fixator was 3.4.

Conclusion
External fixation and ligamentotaxis by either ilizarov or any external fixator is a good and easy method for fixation of distal intraarticulat tibial fracture with few serious complications. due to easy to apply it, less rate of infection, no risk of bleeding since no opening the fracture site, good aligment of the joint, no streaping of the periosteomy that lead to later on good and rapid healing of the fracture.
Recent Trends in the Management of Aneurysmal Bone Cyst
Authors: Sadek Rafeek Ahmed , El Seddawy Ashraf Mohamed , Gomaa Hussein Mohamed Ahmed 
Published: October 2021

Abstract

Background
Aneurysmal bone cysts (ABCs), were first described by Drs. Jaffe and Lichenstein in 1942 when they described pelvic and spine lesions that when exposing the lesion and opening in to its thin wall, the surgeon was immediately confronted by a large hole containing much fluid blood.

Aim of the Work
To describe the efficacy of new line treatment modalities of (Aneurysmal Bone Cysts) compared to conventional lines of management regarding the:
• Long term outcomes and healing rate.
• Recurrence rates.
• Complications after therapy.

Patients and Methods
Criteria for considering studies for this review:
• Types of the studies: published observational analytical studies (case-control_ case-series _ RCT or cohort studies) which studied the efficiency of new lines in the management of aneurysmal bone cyst.
• Types of participants: participants were children and young age (below the age of 50 yrs) with a diagnosis of aneurysmal bone cyst.
• Types of interventions: drugs like (Bisphosphonate or denosumab) were administered for a time determined by the case improvement, or minimally invasive techniques like (cryosurgery or curopsy) was done.

Results
Through the results of our study that compared between these recent modalities according to healing, recurrence, and complications rate; we are able to say that recent strategies have a high rate of healing ranges from 78.57% with bisphosphonate to 100% with doxycycline and cryotherapy.

Conclusion
There are recent evolving trends in the management of ABC other than the classic ways of management, they are less invasive, have less recurrence rate reaches to 0 % like with bisphosphonate, less complications rate as well reaches to 0 % like with doxycycline and bisphosphonate, high healing rate reaches to 100 % like with doxycycline and taking in consideration how to handle cases of ABC that classic way of management can’t handle like spinal ABC.
Oncological Safety of Lipofilling in Patients with Breast Cancer: A Metaanalysis
Authors: Mahmoud Hebatullah Yasser Badr , Setta Hany Saad , El-Shinawi Mohamed 
Published: October 2021

Abstract

Background
Lipofilling is an increasingly popular technique for breast reconstruction following both mastectomy and breast-conserving surgery (BCS). Autologous fat transfer (Lipofilling), is a technique which has been used for many years in the setting of aesthetic breast surgery. Although gaining popularity in this setting, there are still questions regarding its oncological safety when used in patients being treated for breast cancer.

Objective
To systematically evaluate the current literature regarding the oncological safety of lipofilling in patients who underwent surgical treatment for breast cancer by performing a metaanalysis to investigate the recurrence rates and the incidence of complications after lipofilling. Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materi als available in the Internet till 2019.

Data Extraction
All the studies which did not fulfill the inclusion criteria were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion
Through this analysis, no evidence that lipofilling significantly increases the risk of locoregional recurrence when used as part of a breast reconstruction procedure after either mastectomy or BCS for breast cancer was found. Therefore, it can be considered an oncologically safe procedure in suitable patients with careful oncological follow-up. In the future, more longterm, adequately powered, multicentre controlled studies are needed. Additionally, more research should be carried out on the incidence of complications following lipofilling so that efforts can be made to prevent them and optimise fat graft survival.
Ultrasound in Detection of Skull Fractures in Children Younger Than Two Years Old with Closed Head Injuries
Authors: Abdallah Randa , Hemeda Tarek Wahby , Elhady Ahmed Mohamad 
Published: October 2021

Abstract

Background
Paediatrics head injuries is a frequent cause of emergency department (ER) visits. The incidence of head traumas in children varies from one country to other with an estimated 47 to 280 per 100,000 children presented to the ER each year due to traumatic brain injury worldwide. Head computed tomography (CT) is the most frequent CT scan performed in paediatrics population, majority of those scans are done to evaluate trauma. Head CT scans increase the risk of developing brain malignancies and leukemia in exposed pediatric patients. Many efforts have been made to limit the use of CT in children with head injuries.

Aim of the Work
Our aim was to evaluate the role of skull ultrasound in detection of skull fractures children younger than two years old with closed head injuries.

Patients and Methods
Type of study was a prospective observational study, sampling method was convenient sampling. The study was conducted according to the stipulations of the Ain Shams University (ASU) ethical and scientific committee. The privacy of participants and confidentiality of data was guaranteed during the various phases of the study. The study was conducted at the radiology unit, Emergency Department, ASU Hospital. The main source of data for this study was patients referred to the Emergency department. Children younger than 2 years presenting with closed head injuries and referred to the radiology department, ASU hospital to perform CT brain, Study Period: 6 months, onset in March 2020.

Results
We found that skull ultrasound examination of pediatric patients with closed head injuries and Glasgow coma scale (GCS) of 14-15 have a high sensitivity and specificity in detecting skull fractures and subsequently prediction of an underlying traumatic brain injury (TBI) in these patients. Ultrasonographic assessment of the whole cranial vault is not always feasible as most of these age group patients are excessively crying and irritable at presentation, applying the ultrasound probe makes them more irritable and are difficult to maintain their head position during the scan. Although head CT is the gold standard diagnostic modality in the setting of head trauma, it exposes patients to significant ionizing radiation, ultrasonography is a safe diagnostic modality and doesn’t expose the patient to ionizing radiation.

Conclusion
Skull ultrasound in the setting of pediatrics mild closed head injuries is feasible, safe, sensitive and specific. It can play a complementary rule in risk stratification of these patients.
The role of Sonoelastography in characterization of solid breast lesions
Authors: Ghanem Alaa Othama Hendawy , Abd Elkhalek Yasser Ibrahim , Abd Elmoteleb Mohamed Gamal Aldin 
Published: October 2021

Abstract

Background
Mammography and Sonography are the important sensitive imaging modalities available in detection of breast cancer.
Sonoelastography is a relatively new imaging technique which acts as a complementary tool to improve the diagnostic ability of ultrasound for evaluating patients with breast masses.

Objective
To evaluate the role of sonoelastography characterization information on solid breast lesions over conventional sonography and mammography either benign or malignant lesions to reduce the number of benign biopsies performed.

Methods
A prospective study was carried at private centers, starting from august 2019 till december 2019.

Results
The study conducted on 40 patients with palpable breast lesions classified to BIRADS 3 and 4a according to conventional ultrasound and mammographic criteria. Their ages ranged from 18 to '75 years with a mean age 47.72 14.91, 22 cases (55%) had no family history of pervious breast disease, and 18 cases (45%) had family history of pervious breast disease.
All patients were subjected to full history taking, clinical examination, conventional gray scale ultrasound, and mammography and ultrasound elastography.
All patients underwent histopathological assessment to reach the final diagnosis.
Among Studied cases , 28 lesions were sampled by fine needle biopsy (70%) and 12 lesions were sampled by true cut needle (30%) .the results revealed 27 breast lesions were benign (67.5%), 9 malignant lesions (22.5%) and 4 lesions shows atypia (10%) according to histopathological assessment.
Among final diagnosis of breast lesions fibro adenoma was the most frequent benign breast lesion detected as 12 lesions from 27 benign breast lesions were fibroadenoma., Also infiltrative ductal carcinoma was the moste frequent among malignant breast lesions as 5 lesions from 9 malignant lesions were infiltrative ductal carcinoma.

Conclusion
Ultrasoundelastography has significant complementray role beside conventional mammogram and ultrasound in characterization of solid breast lesions.
Micro structural abnormalities of the Cingulum in children with focal epilepsy: DTI study
Authors: Abdurrahman Laila Ahmad , Younis Neveen Tawakol , Mohammad Shaimaa Abdelsattar , Aly Nour El Dein Aly Haggag 
Published: October 2021

Abstract

Aim of the work
The aim of this study is to evaluate the microstructural alteration implicating the Cingulum (CG) as one of the major limbic system white matter fiber tracts; in children with focal epilepsy.

Patients and methods
Our study was carried out on twenty-one children with the clinical and EEG diagnosis of focal epilepsy and 22 control subjects who were age and sex matched to patient group in the study. All patients underwent an epilepsy specific MRI protocol. DTI and fiber tractography was performed to all subjects as well. Fractional anisotropy (FA), axial diffusivity, radial diffusivity (RD) and trace were calculated for CG. DTI metrics were compared between both hemispheres as well as between both groups patient group and control group. A p-value less than .05 was considered significant.

Results
Asymmetry in FA, RD, trace and AD values of the CG was demonstrated in patients with focal epilepsy between both hemispheres with significantly lower FA and higher diffusivity values reaching p &lt; 0.001in CG in both hemispheres in patients with focal epilepsy when compared together regardless the seizure focus. Compared with controls, patients with left focal epilepsy demonstrated significant lower FA and higher diffusivity indices in both ipsilateral and contralateral fiber tracts as well p &lt; 0.05. Patients with right focal epilepsy showed no significant asymmetry in different DTI metrics when compared to controls.

Conclusion
Reduction in FA values along with increased diffusivity measures in the CG reflects the microstructural changes taking place in children with focal epilepsy.
Role of FDG-PET CT in differentiating adenocarcinomas from squamous cell carcinomas of the lung
Authors: Salem Amr Muhammad Abdo , Hussein Laila Hosny , Osman Ahmed Mohamed 
Published: October 2021

Abstract

Background
Lung cancer is the leading cause of cancer related deaths worldwide. The combination of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) has a great impact on the diagnosis, staging, and hence on the treatment plan and follow up of lung cancer patients. Maximum standardized uptake value (SUVmax) is a semi-quantitative index which is easily performed and the most widely used quantitative parameter for the analysis of 18F-FDG PET images and for the estimation of metabolic activity.

Objective
to investigate the role of PET/ CT to differentiate between adenocarcinomas (AC) and squamous cell carcinomas (SCC) as the most common lung cancer by comparing their FDG uptake measured in the form of SUVmax.

Methods
A retrospective observational study, conducted at Ain Shams University Hospitals- Radiology Department patients diagnosed with non-small cell lung cancer (NSCLC) and histopathologically proved to be adenocarcinoma or squamous cell carcinoma. All were investigated using PET/CT scans in the period between June 2017 to September 2019. SUVmax of the lesion were measured and statistically analyzed compared with the histopathological type.

Results
A total of 30 patients were evaluated with the age ranging from 31 to 81 years old, the mean was 56.9 years (SD ± 11.53). Among them 25 patients (83.3%) were males and 5 patients (16.7%) were females. Out of the 30 NSCLC patients included in the study, 18 patients (60%) were histopathologically diagnosed as AC and 12 patients (40%) were histopathologically diagnosed as SCC. The mean SUVmax of the 30 NSCLC lesions was 15.02±8.4 (range: 2-32.8).The mean SUVmax of AC lesions was 12.4±7.55 (range: 2-32.8), while the mean SUVmax of SCC lesions was 18.95±8.3 (range: 3.7-30.77). The mean SUVmax of lesions in patients with SCC was significantly higher than that of patients with AC using Wilcoxon-Mann-Whitney test (P = 0.04).

Conclusion
SCC of the lung has higher SUVmax than AC of the lung and it can be used to differentiate between them using PET/CT.
Role of CT and modified Response Evaluation Criteria in Solid Tumors (RECIST criteria) in response evaluation of malignant pleural mesothelioma
Authors: Allam Ass Prof .Dr., Khalid Esmat , Ali Hassan Hend Galal Eldeen Mohamed , Mohamed Basma Abdelbaset 
Published: October 2021

Abstract

Background
Malignant pleural mesothelioma is a rare and aggressive tumor that the growth pattern of it poses unique difficulties in measurement and response assessment . however, robust and reproducible assessment of response is critically important in the conduct, interpretation, and reporting of clinical trials.

Objectives
The aim of this study is to assess the value of CT and modified RECIST criteria in follow up patients of malignant pleural mesothelioma patient during treatment with chemotherapy .

Patients and methods
We evaluated 20 malignant pleural mesothelioma patients undergoing to chemotherapy . Tumor thickness is measures perpendicular to the chest wall or mediastinum in two positions at three separate levels on thoracic CT scans. The sum of the six measurements defined a pleural unidimensional measure. A reduction of at least 30% on two occasions 6 weeks apart defined a partial response; an increase of 20% over the nadir measurement known as progressive disease. Patients who fulfilled the criteria for neither PR nor PD called CD .The validity of the modified criteria was gauged by clinical evaluation .

Results
In our study, CT and modified RECIST criteria were used as the method of choice in response evaluation of malignant pleural mesothelioma .Our study showed as follow up results of each group and comparison between clinical evaluation and modified RECIST criteria show over all accuracy 73.3% with P value = 0.03 and this results confirm accuracy of CT with modified RECIST criteria as good predictor of disease outcome .

Conclusion
These Modified RECIST criteria for tumor response correlate with clinical evaluation and can be used to measure outcome in pleural mesothelioma.
MRI versus US in diagnosis of meniscal injury in the knee joint
Authors: MBChB Nourhan Nasery Demian Saad , Nassef Hana Hamdy , Shalaby Mennatallah Hatem 
Published: October 2021

Abstract

Background
Meniscal injuries are the most common type of knee injuries.MRI is the gold standard in the diagnosis of meniscal injuries.

Aim of the work:-
The aim of this study is to compare between the accuracy of ultrasound and MRI in diagnosis of meniscal injury.

Patients and Methods:-
This study was carried out at the Radiology Department, AinShams University Hospitals.Twenty patients with proven MRI meniscal tear underwent ultrasound(US) examination.

Results :-
The overall sensitivity of the US to diagnose meniscal injuries reached (85.0%), specificity (100%) and accuracy (92%),