bluuebunny/crossref_metadata_2025_split huggingface dataset:
Induction of Abortion in the Second Trimester by Misoprostol or Misoprostol with Letrozole
Authors: Kortam Mohamed Ashraf Mohamed Farouk , Raafat Tarek Aly , Rahman Rehab Mohamed Abd El , Mahfouz Amir Hamdy Abd El Hady 
Published: October 2021

Abstract

Background
Abortion is the termination of pregnancy by any means (surgical or medical) before the age of viability. The definition varies in duration of gestational age according to the countries and available facilities. Estrogen is important in the maintenance of pregnancy. Aromatase inhibitors such as letrozole, suppress the peripheral conversion of androgen to estrogen, the use of letrozole combined with vaginal misoprostol was more effective than misoprostol alone in termination of pregnancy.

Objective
Assessing the efficacy of addition of letrozole to Misoprostol in medically induced abortion in the second trimester of pregnancy in the Maternity hospital of Ain Shams University.

Methods
This clinical trial was conducted at Ain Shams University Maternity hospital in the period between December 2018 and May 2019. Patients that seem to be fulfilling the inclusion criteria were recruited, then informed written consent was taken from every patient before starting the examination That was followed by detailed history and examination of all patients to confirm fulfilling the inclusion and exclusion criteria.

Results
This study demonstrated that 10 mg letrozole for three days followed by 800 mcg of vaginal misoprostol is more effective than misoprostol alone for second trimester abortion. In the total of 72 women were recruited the complete abortion rate of the letrozole group was significantly higher than that of the control group (61,1% in the letrozole group compared with 33,3% in the control group).

Conclusion
s: The use of letrozole in addition to misoprostol was associated with a higher complete abortion rate, shorter induction to abortion interval and shorter curettage rates compared to a placebo followed by misoprostol in patients undergoing induction of abortion between 12 & 24 weeks gestation.
Combined Use of Vaginal Misoprostol with Intracervical Foley Catheter Versus Vaginal Misoprostol alone in Induction of Labor at Term Pregnancy
Authors: Swidan Khaled Hassan , El-Shahawy Ahmed Abdel Shafy , Abbass ; Ahmed Mohamed , Mohamed Huda Mohamed Elsayed 
Published: October 2021

Abstract

Background
Induction of labor should be used in the most efficient way possible that will result in a favorable obstetric outcome with minimum fetal morbidity.

Objectives
The aim of this study is to compare the efficacy and safety of intravaginal misoprostol alone versus intra cervical Foley catheter combined with vaginal misoprostol in induction of labor at term pregnancy.

Methods
This study was conducted at Obstetrics & Gynecology Department; Ain Shams University, Maternity Hospital in the period between May 2017 to October 2017. The total number of patients studied was 120 patients, divided into two groups; the first group (A) included 60 patients who received vaginal misoprostol, the second group (B) included 60 patients who received vaginal misoprostol combined with trans cervical Foley catheter.

Results
The current study found that the combined group has a better chance for NVD 88.3% versus 78.3% in misoprostol alone group, a lesser probability to CS 11.7% in combined group versus 21.7% in misoprostol alone group and a shorter induction delivery interval within 12 hours after induction (81.6% in combined group versus 59.5% in misoprostol group). Regarding the effect of both methods on fetal safety, we found that non reassuring FHR was more common in combined group 8.3% than misoprostol alone group 1.7% but it’s statistically non-significant. There was statistically significant increase in tachysystole in combined group 28.3% versus 13.3% in misoprostol alone group. However, dystocia was more common in misoprostol group 15% than combined group 3.3% that is also statistically significant.

Conclusion
Both methods can be used in induction of labor at term pregnancy without forgetting the precautions and close observation to the mother and the fetus. Combined method results in a shorter induction-to delivery time, but misoprostol alone was safer for the mother and the fetus.
Relationship between Transvaginal Ultrasound Endometrial Volume, Body Mass Index and Endometrial Pathology in Women with Postmenopausal Bleeding
Authors: Sokkary Mohammed Salah El , Ghaleb Mahmoud Mohamed , El Helw Rowyna Hany Mohamed 
Published: October 2021

Abstract

Background
Menopause is recognized to have occurred after one year of amenorrhea, for which there is no other obvious pathological or physiological cause. Perimenopause should include the period immediately prior to the menopause (when the endocrinological, biological and clinical features of approaching menopause commence) and the first one year after menopause.

Objectives
The aim of the study is classification of patients into those with benign endometrial pathology and those with endometrial hyperplasia or carcinoma using endometrial volume and BMI.

Patients and Methods
This observational cross sectional study was conducted at the Department of Obstetrics and Gynecology in Ain Shams University Hospital from March 2019 till January 2020. The population of this study was 100 menopausal women with postmenopausal bleeding ≥12 months and endometrial thickness by TVUS ≥5 mm.

Results
According to histopathology of endometrial carcinoma, statistical analysis of our data revealed that age, menopausal duration and BMI were significantly highest. Parity was significantly lowest. Endometrial volume was significantly highest in carcinoma (7.9±2.9 cc). Age, menopausal duration, parity and endometrial volume had significant moderate diagnostic performance in predicting endometrial carcinoma but BMI had significantly low. Age ≥ 62.0, menopausal duration ≥ 11.0 and parity ≤3.0 had low diagnostic characteristics in diagnosis of endometrial carcinoma but endometrial volume ≥ 6.0 had high sensitivity but low other diagnostic characteristics in the diagnosis of endometrial carcinoma. According to histopathology of endometrial hyperplasia, statistical analysis of our data revealed that age, menopausal duration, BMI, parity and endometrial volume had no significant diagnostic performance in the diagnosis of endometrial hyperplasia.

Conclusion
In our study, analysis of data revealed that the using of transvaginal measurement of endometrial volume is the best predictor of endometrial cancer with a positive correlation with BMI.
Evaluation of Serum level of thrombomodulin in cases with preeclampsia
Authors: Taleb Yasser M. Abou , Mohammed Hayam F , El-Khazragy Nashwa N , Ahmed Sohaila K 
Published: October 2021

Abstract

Background
Preeclampsia is a multisystmic disorder of unknown cause. Endothelial cell damage has recently been suggested to underlie the pathologic change in preeclamptic pregnancy. Thrombomodulin an endothelial cell surface glycoprotein act as a co-factor for thrombin catalyzed activation of protein C. activated protein C inhibits coagulation by inactivation the coagulation factor Va and VIIIa.

Aim of the Work
to assess the changes in thrombomodulin level in women with preeclampsia.

Patients and Methods
This prospective case-control study was conducted on 123 women at Ain Shams University Maternity Hospital.

Results
Regarding clinic-pathological features of pre-eclampsia patients and healthy control groups, our study found that there was high significant difference (p ≤ 0.01) between hypertensive and normal patients regarding (hypertension, obesity and history of PET). Our study found that there was high significant difference (p ≤ 0.01) between pre-eclampsia patients and healthy control group regarding serum thrombomodulin protein level and serum thrombomodulin protein increases significantly with mild and severe preeclampsia and HELLP syndrome and considered a good marker for evaluation of hypertensive patients with pregnancy.

Conclusion
serum thrombomodulin protein level is considered a good marker for evaluation of hypertensive patients with pregnancy.
Antenatal Azithromycin to Prevent Preterm Birth in Pregnant women with Vaginal Cerclage. A Randomized Controlled Trial
Authors: Mostafa Rania Hassan , Ashoush Sherif Ahmed , Bayoumy Hassan Awwad , Gabr Wessam Kamal Lotfy 
Published: October 2021

Abstract

Background
Preterm birth with its complications is one of the leading causes of perinatal morbidity and mortality, as well as maternal morbidity, especially in low and middle-income countries. Cervical cerclage is a well-established preventive tool in women at high risk of preterm birth; however, subclinical maternal infection might still cause failure of this method. Thus, adding prophylactic antibiotics, namely macrolides, could prevent preterm birth.

Patients and methods
This was a randomized controlled clinical trial involving two groups of women who underwent vaginal cerclage at Ain Shams University Maternity Hospital. One group received azithromycin 500mg one tablet orally once daily for 3 days every month from 14th week to 34th week gestation, in addition to routine antenatal care; while the other group received usual antenatal care without antibiotic prophylaxis after cerclage. Follow-up was done and we compared the outcomes in each group: gestational age at delivery, birth weight, mode of delivery, maternal complications, and perinatal complications. ClinicalTrials.gov Identifier NCT04278937.

Results
Gestational age at delivery was significantly higher in the azithromycin group (36.8weeks vs 34.1weeks; P = 0.017), with significant prolongation of gestation in the azithromycin group (23.7weeks vs 21.1weeks; P = 0.005). As regards birth weight, it was significantly higher in the azithromycin group (2932.6gm vs 2401.8gm; P = 0.006); however babies with low birth weight (birth weight &lt;2500gm) were non-significantly less frequent in the azithromycin group (3cases vs 7cases; P = 0.165). There was no significant difference between the two groups as regards other outcomes (miscarriage, stillbirth, neonatal intensive care unit admission, antepartum hemorrhage, postpartum pyrexia, need for blood transfusion).

Conclusion
Adding azithromycin as antenatal prophylaxis in women undergoing vaginal cerclage prolongs pregnancy and reduces risk of PTB, with slight increase in birth weight. However, there was no clear effect on incidence of low birth weight, or perinatal morbidity/mortality.
Relation between Circulating Vitamin k2 level and Osteoporosis in Post-Menopausal Women
Authors: Abdel Aziz Dina M , Saleh Hala A , Taha Neven M , Elbadawy Mohga A 
Published: October 2021

Abstract

Objective
We aimed to measure the serum level of vitamin k2 in postmenopausal osteoporotic patients to determine its role in the disease.

Patients and Methods
Our study was designed as a cross sectional study, with 15 postmenopausal osteoporotic patients (with reduced bone mineral density BMD), aged between 54-58 years old compared to 15 healthy controls (with normal BMD at all of lumbar spine, femoral neck and hip) matched in age with the patients. All participants were subjected to full medical history taking, physical examination and functional assessment of the activity of daily livings (ADL). Biochemical assays of thyroid stimulating hormone, parathyroid hormone, total calcium, phosphorus, alkaline phosphatase (ALP), 25-hydroxyvitamin D (25 (OH) D), erythrocyte sedimentation rate, Kidney and liver function tests and serum levels of vitamin k2 were performed.

Results
The patients showed highly significantly lower vitamin k2 levels (P &lt; 0.05) and non-significant correlations between vitamin k2 and the activity of daily living (ADL) nor the other laboratory assessment parameters (P &gt; 0.05) among the patient’s group.

Conclusion
Vitamin K deficiency is highly prevalent in the majority of our patients and should be considered an associating factor in the etiology of postmenopausal osteoporosis. Vitamin k2 deficiency could result in a decrease in the bone mineral density in postmenopausal women, so vitamin k2 levels should be checked in post-menopausal osteoporosis and any deficiency must be treated and corrected to improve the bone mineral density.
Comparative study between the effect of mesenchymal stem cells and/or platelet-rich plasma on bone parameters in ovariectomized mature rats
Authors: Hamed Gehane M , Nassef Noha A , Eissa Rania S.A , Shawky Mona K.E , Abo Zeid Asmaa A , Hassan Arwa A 
Published: October 2021

Abstract

Background
Osteoporosis is a common bone disease and is associated with considerable morbidity and mortality. Osteoporosis occurs most frequently in postmenopausal women. The inadequacy of current treatments and their side effects have driven a search for improved methods of dealing with osteoporosis.

Design
Experimental study.

Aim of Work
This study was conducted to throw light on the ability of BM-MSCs and/or PRP in improving bone formation and slow down bone loss in ovariectomized rats with osteoporosis.

Materials & Methods
This study was carried out on adult female Wistar rats allocated randomly into five groups: Sham-operated, OVX untreated, OVX-MSCs treated (MSCs administered once intravenously), OVX/PRP treated (PRP administered once subcutaneously), OVX-MSCs/PRP treated groups. Rats were subjected to assessment of serum ALK, CTX-1, MDA and TNF-α. In addition, specimens of tibia were taken and processed for light microscopic studies and morphometric analysis.

Results
OVX untreated group showed significant increases in serum levels of ALK and CTX-1. Significant elevations of serum MDA and TNF-α levels were also noticed in the OVX untreated group. Administration of BM-MSCs and PRP significantly lowered serum levels of ALK, CTX-1, MDA and TNF-α. These results were confirmed by the histopathological findings.

Conclusion
BM-MSCs together with PRP can partially reverse OVX-induced bone loss and halt osteoporosis progression.

Abbreviations
BM-MSCs: bone marrow derived mesenchymal stem cells, PRP: platelet-rich plasma, OVX: ovariectomized, ALK: alkaline phosphatase, CTX-1: cross linked c telopeptide of type 1 collagen, MDA: malondialdehyde, TNF-α: tumour necrosis factor-alpha.
Workplace violence among nurses and physicians in a tertiary teaching hospital in Egypt
Authors: Abozaid Dena Ali , Momen Mohamed , Ezz Nahla Fawzi Abou El , Ahmed Hanaa Abdelhakiem , Al-Tehewy Mahi Mahmoud , Houssinie Moustafa El 
Published: October 2021

Abstract

Background
Workplace violence (WPV) has been recognized as a major occupational hazard worldwide. Healthcare professions are particularly at a higher risk of WPV. Reported magnitude of WPV represents only the tip of an iceberg. The consequences of WPV in healthcare sector are dramatic; it affects the wellbeing of healthcare professions as well as the quality of the delivered service.

Objective
The study aimed to measure the magnitude of WPV, to identify factors associated with WPV among nurses and physicians working in a tertiary teaching hospital in Egypt.

Methodology
A descriptive cross-sectional study was conducted. A total of 114 physicians and 128 nurses were interviewed about exposure to WPV within the previous 12 months.

Results
The study found a high magnitude of WPV; nearly three fourth of physicians and nurses experienced violence in the workplace within the past 12 months. Female physicians experienced WPV more commonly compared to male physicians. There was a statistically significant association between type of patient nurses commonly cared for and experiencing WPV.

Conclusion and Recommendations
WPV among healthcare professions is an increasing problem that needs to be addressed. Increasing awareness of the problem among healthcare professions as well as the general public is warranted. Violence prevention program with a zero-tolerance policy is warranted.
Work Related Stress and its Effect on Mental Health among employees of Ain Shams University Hospitals
Authors: Ibrahim Noha M , Gadallah Mohsen A , Kandil Sahar K , El-Din Dina A. Gamal 
Published: October 2021

Abstract

Background
Work related stress reduces the overall mental and physical wellbeing of employees. Workers in health industry are more prone to work stress than any other workplace. Many researches were conducted among health-care professionals, but not among hospital employees who are not involved in the direct patient’s care.

Objectives
This study was aiming to measure the prevalence of work related stress among employees of Ain Shams University Hospitals, to determine its risk factors and to measure its effect on the occurrence of depression, anxiety and stress.

Method
A cross-sectional study was conducted upon a sample of employees in Ain Shams University Hospitals, working in the same job for at least one year and not involved in direct patient’s care. Employees were interviewed using the “workplace stress scale”, the “Depression Anxiety Stress Scale DASS-21”, and the “socioeconomic status scale for health research in Egypt” by El-Gilany.

Results
The study included 462 participants, their age ranged from 18 to 59 years (mean ± SD: 43.4 ± 10.9), 171(37%) were males and 291 (63%) were females, and the majority were in the middle and high social class (79.2% and 16.9%) respectively). Most of the employee experienced work-related stress: 40 (87.7%) of them, the moderate, severe, and dangerous levels were 32.3%, 22.5% and 7.6% respectively. Work-related stress was significantly associated with job category with engineers were the least stressed (50%) and workers were the most (94.1%). The majority of participants suffered any of the three mental ill-health and the frequency of depression, anxiety and stress (312 (67.5), 319 (69.0) and 239 (51.7) respectively). Severe/extremely severe levels of depression, anxiety and stress were observed among 20.8%, 34.6% and 17.6% of participants respectively. Work related stress was significantly associated with the three mental ill-health status.

Conclusion
This study revealed a high level of workrelated stress among hospital employee who are not involved in patient’s care with around fifth of them suffered severe levels of mental ill-health. Occupational stress resulted mainly from inadequate control over work duties and unpleasant or unsafe work conditions.
Participation and Satisfaction with the National Campaign on Viral Hepatitis C and Non-Communicable Diseases among Administrative Workers of Ain Shams University, Cairo, Egypt
Authors: Abd-ElSamad Nourhan B , Basyoni Nashwa I , Allam Mohamed F , El-Damaty Samia I 
Published: October 2021

Abstract

Background
On the first of October,2018, the Egyptian Ministry Of Health and Population (MoHP) launched an initiative; named 100 Million Seha, for nationwide screening of hepatitis C virus (HCV) and major non communicable diseases (NCDs) diabetes, hypertension and obesity. Egypt has one of the highest prevalence rate of HCV infection in the world and NCDs are considered the leading cause of mortality in Egypt

Objectives
This study aimed to estimate the prevalence rate of participation of ASU workers in the Egyptian Initiative 100 Million Seha and to assess their level of satisfaction.

Method
A cross sectional study was conducted on 400 Administrative workers of Ain shams university faculties between March and August, 2019 in Cairo, Egypt. A multistage random sample was applied.

Results
Most of the study group (96%) had participated in the campaign.“Reassurance about health” was considered the main reason for participation (92%), followed by “desire to obtain follow up card”, (36%). the main cause of non-participation was fear of needle prick. About 91% of the participants were satisfied with the services provided by the campaign. Mass media was the main source of information (91%).

Conclusions
Most of the study group participated in the initiative 100 Million Seha and were satisfied with the service provided. Mass media played the most important role in awareness with the campaign.
Depression Moderates Physical Functioning Over Time in Survivors of Cancer
Authors: Bamonti Patricia M. , Weiskittle Rachel E. , Naik Aanand D. , Bean Jonathan F. , Moye Jennifer A. 
Published: October 2021

Background:
Cancer survivors are at risk for declines in physical functioning (PF). The strongest predictor of PF is prior PF. Clinically significant depression predicts declines in PF; however, the extent to which depression symptoms moderate the association between self-reported and performance-based measures of PF over time is unknown.

Objective/Purpose:
To examine whether level of depression symptoms in cancer survivors moderates the association of repeated self- and performance-based measures of PF at 6 and 18 months after cancer diagnosis.

Methods:
Prospective, observational study with assessment at 6 (T1), 12 (T2), and 18 months after cancer diagnosis (T3).

Setting and Patients:
Community-dwelling US veterans with newly diagnosed head and neck, esophageal, gastric, or colorectal cancers.

Measurements:
Measures included demographics, cancer variables (type, stage, severity, and treatment), depression symptoms (Patient Health Questionnaire-9 [PHQ-9]), Short Physical Performance Battery (SPPB), and self-reported PF (Patient-Reported Outcomes Measurement Information System-29 [PROMIS-29]).

Results:
Using hierarchical regression models, after adjustment for covariates, depression symptoms at T2 moderated the relationship between performance-based PF, SPPB (β = −0.24, P = .001) but not self-reported PF, PROMIS (β = −0.14, P = .05). In moderation analyses, SPPB T1 was only related to SPPB T3 when the PHQ-9 score was less than 9.

Limitations:
Majority White, male participants, did not measure chronicity of depression.

Conclusions:
Depression symptoms moderate the relationship of performance-based PF from baseline to 18 months.
Efficacy and Safety of Pectoral Nerve Block (Pecs) Compared With Control, Paravertebral Block, Erector Spinae Plane Block, and Local Anesthesia in Patients Undergoing Breast Cancer Surgeries
Authors: Elshanbary Alaa Ahmed , Zaazouee Mohamed Sayed , Darwish Youssef Bahaaeldin , Omran Maha Jabir , Elkilany Alaa Yousry , Abdo Mohamed Salah , Saadeldin Ayat M. , Elkady Sherouk , Nourelden Anas Zakarya , Ragab Khaled Mohamed 
Published: October 2021

Objective:
We aimed to compare the safety and efficacy of pectoral nerve block (Pecs) I and II with control or other techniques used during breast cancer surgeries such as local anesthesia, paravertebral block, and erector spinae plane block (ESPB).

Methods:
We searched 4 search engines (PubMed, Cochrane Library, Scopus, and Web of Science) for relevant trials, then extracted the data and combined them under random-effect model using Review Manager Software.

Results:
We found 47 studies, 37 of them were included in our meta-analysis. Regarding intraoperative opioid consumption, compared with control, a significant reduction was detected in Pecs II (standardized mean difference [SMD]=−1.75, 95% confidence interval [CI] [−2.66, −0.85], P=0.0001) and Pecs I combined with serratus plane block (SMD=−0.90, 95% CI [−1.37, −0.44], P=0.0002). Postoperative opioid consumption was significantly lowered in Pecs II (SMD=−2.28, 95% CI [−3.10, −1.46], P<0.00001) compared with control and Pecs II compared with ESPB (SMD=−1.75, 95% CI [−2.53, −0.98], P<0.00001). Furthermore, addition of dexmedetomidine to Pecs II significantly reduced postoperative opioid consumption compared with Pecs II alone (SMD=−1.33, 95% CI [−2.28, −0.38], P=0.006).

Conclusion:
Pecs block is a safe and effective analgesic procedure during breast cancer surgeries. It shows lower intra and postoperative opioid consumption than ESPB, and reduces pain compared with control, paravertebral block, and local anesthesia, with better effect when combined with dexmedetomidine.