bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinal Nerve Fibre Layer Assessment in Glaucoma and Glaucoma Suspect by Optical Coherence Tomography (OCT)
Authors: El-Dabae Ahmed Mohamed , Omar Rashed Mohamed , Zaky Mohamed Abd El-Hakim , Ebeid Weam Mohamed Ahmed 
Published: October 2021

Abstract

Background
Glaucoma is a progressive optic neuropathy characterized by structural changes in the optic nerve head, retinal nerve fiber layer (RNFL) defect, and accompanying visual field damage (VFD). In glaucoma management, detecting progression is essential in both early and late stages of the disease. In patients with an established diagnosis of glaucoma, evidence of progression will influence a clinician’s decision whether to modify glaucoma therapy. In patients who are suspected of having the disease, progression detection can confirm the diagnosis, and help decide how to manage the patient. Although standard automated perimetry has been the most commonly used test to monitor glaucomatous progression, evidence suggests that in some eyes substantial structural damage can be detected before the development of clinically detectable VFD.

Objective
To compare retinal nerve fibre layer thickness between glaucoma and glaucoma suspects.

Methods
We conducted our cross sectional comparative study on Forty eight eyes from patients recruited from Ain Shams University Hospitals, Ophthalmology Department during the period from February 2019 to December 2019. The Forty eight eyes were recruited in this study and divided into 2 groups. Group A- (Twenty-four eyes with moderate open angle glaucoma) and Group B- (Twenty four eyes with criteria of glaucoma suspects).

Results
There was highly Significant difference as regards OCT parameters of the patients (p &lt; 0.001 for all). As the mean value of Cup/disc ratio was lower in Glaucoma Suspected cases, while Total RNFL, RNFL Superior and RNFL Inferior was higher in Glaucoma Suspected cases than patients with Moderate glaucoma. This study showed that; by using ROC-curve analysis, cup to disc ratio (CDR) at a cutoff point (&gt;0.59) detected patients with glaucoma, with excellent accuracy, sensitivity= 95% and specificity= 100%. Also, by using ROC-curve analysis, superior RNFL at a cutoff point (≤116) detected patients with glaucoma, with fair accuracy, sensitivity= 66% and specificity= 91%. While inferior RNFL at a cutoff point (≤113) detected patients with glaucoma, with good accuracy, sensitivity= 70% and specificity= 95%.

Conclusion
In conclusion, structural progression measured using SD OCT was associated with functional progression shown in VF loss in glaucoma suspect or preperimetric glaucoma eyes and in glaucomatous eyes. Average, inferior and superior RNFL attenuations were the most important risk factors for visual field progression.
Corneal epithelial mapping in different corneal conditions
Authors: El-Hennawi Fatma , Rashed Hazem , Fawzy Reham , Selim Kholoud 
Published: October 2021

Abstract

Background
Cataract surgery is traumatic to the corneal epithelium,scarring and opacity is the commonest cause of blindness.

Objective
To study the corneal epithelial thickness in different corneal conditions using anterior segment optical coherence tomography (AS-OCT).

Patients and Methods
A case-control study including 80 eyes divided equally into 4 groups; group 1:controls,group 2:corneal scarring ,group 3:cataract patients and group 4:pterygium. using AS-OCT epithelial mapping to document changes in epithelial thickness in controls, cataract patients pre and 1 month after phacoemulsification, patients with corneal scarring and patients with pterygium.

Results
In phacoemulsification group; we found that epithelial thickness became thinner in area (0_2) and thicker in area (7_9) mm in the map with no significant change in areas (2_5),(5_7) mm in the map. In corneal scarring group; we found that epithelial thickness became thicker compared to control group in all zones. In pterygium group; we found that epithelial thickness became thicker compared to control group in, areas (2_5), (5_7) & (7_9) mm in the map with no significant change in area (0_2) mm in the map.

Conclusion
The corneal epithelium thickness becomes thinner or thicker to compensate for changes in stromal thickness.
Efficacy of posterior sub-Tenon’s capsule injection compared to intravitreal injection of triamcinolone acetonide for treatment of diabetic macular edema: A systematic review and meta-analysis
Authors: Ibrahim Mohamed H , Salman Abdelrahman G , Said Azza M , Al-Feky Mariam A , Moustafa Moustafa E 
Published: October 2021

Abstract

Background
Diabetic macular edema (DME) is defined as a retinal thickening in one-disc diameter (DD) of the centre of the macula. It is a number of microvascular retinal changes that lead to blood–retinal barrier (BRB) disruption, causing leakage of fluid and plasma components into the inner and outer plexiform layers.

Aim of the Work
to conduct a systematic review and a meta-analysis estimating the efficacy and complications of posterior sub-Tenon’s capsule injection of triamcinolone acetonide (STTA) compared to intravitreal injection of triamcinolone acetonide (IVTA) for management of DME.

Materials and Methods
A comprehensive literature search was conducted using the databases Google scholar, PubMed, MEDS, web of science, EMBASE and Cochrane Library for published studies from 1 January 2000 to 1 September 2019.This meta-analysis included ten studies. They were randomized controlled clinical trials (RCTs), and about 343 patients with DME (469 eyes) participated in these studies.

Results
: This study demonstrated a statistically significant change in the mean of best corrected visual acuity (BCVA) improvement and central macular thickness (CMT) reduction in both groups when comparing the baseline to one- and three-month follow-ups after the injection, though with no statistically significant difference in the IVTA compared to the STTA group. At a six-month follow-up, both groups showed no significant differences in the BCVA and CMT compared to the baseline. Both groups showed no statistical differences in the BCVA or CMT over the follow-up periods. Regarding intraocular pressure (IOP) changes, the present study showed that the mean IOP was elevated in both groups at one- and three-month follow-ups after the injection compared to their baseline. There was a statistically significant difference between both groups at one and three-months. The IOP was more elevated in the IVTA compared to the STTA group. At a six-month follow-up, both groups showed no significant difference in the IOP elevation compared to the baseline. IOP elevation was the most reported adverse effect in all included studies. Cataract formation is also reported in some studies, though no other complications, such as endophthalmitis, vitreous hemorrhage (VH), and/or retinal detachment (RD), are reported in any of the studies.

Conclusion
: STTA injection has a comparable effect to the IVTA injection and carries a lower risk of intraocular complications. It is considered an easy, safe, and valid alternative to the intravitreal injection for the treatment of DME.
Prevalence of Diabetic Retinopathy among Type Two Diabetic Patients in Arab Countries
Authors: Awad El-Hariri Mona Mohsen Mahmoud , Al-Ebiary Hany Hasan , Elewa Lamia Salah , Moustafa Moustafa El-Husienni 
Published: October 2021

Abstract

Background
Diabetes mellitus (DM) is a metabolic disorder characterized by chronic hyperglycaemia. Diabetes causes many complications like diabetic retinopathy (DR) which affects up to 80 percent of all patients who have diabetes for more than 10 years or more.

Objectives
To estimate the prevalence rate of diabetic retinopathy among type 2 diabetic (T2D) patients in some Arab countries and to compare the difference in the prevalence rate according to different patient’s characteristics.

Patients and Methods
In recent years, several studies have indicated occurrence of peripapillary retinal nerve fiber layer (RNFL) thinning in the retina of diabetic patient. We reviewed the full articles of the extracted 17 different studies across 10 Arab countries that were captured through our search strategy. Through 25 years (1991– 2016), most of the studies re-ported were carried, we captured 17 studies through our systematic search.

Results
The prevalence rate of diabetic retinopathy among type 2 females is 19.848%. The prevalence rate of diabetic retinopathy among type 2 males is 18.559%. Prevalence of Diabetic Retinopathy in those with up - 5 years duration of the disease is 7.597%. Prevalence of Diabetic Retinopathy in those with 5-10 years duration of the disease is 24.418%. Prevalence of Diabetic Retinopathy in those with &gt;10 years duration of the disease is 52.913%. Prevalence of Diabetic Retinopathy in those aged &lt;45 years is 9.505%. Prevalence of Diabetic Retinopathy in those aged 45-55 years is 20.346 %. Prevalence of Diabetic Retinopathy in those aged &gt;55 years is 25.297%.

Conclusion
We present the first systematic review and meta-analysis of DR among Arab patients with T2D in 10 different Arab countries. Although our search strategy was broad, we were only able to find few reports compared to the scale of the problem in the Arab countries; our meta-analysis revealed that the prevalence is high (22.543 %) with significant variations among different Arab countries, even within the same country.
Comparative Study between Generic versus Brand Latanoprost in treatment of Open Angle Glaucoma Patients
Authors: Mansour Noha Abo Amer Ibrahim , Shafik Mohammed Adel Abdel , Hamdi Momen Mahmoud , Shaat Ashraf Abdel Salam 
Published: October 2021

Abstract

Background
Glaucomas are a group of optic neuropathies characterized by progressive degeneration of retinal ganglion cells. Degeneration of these nerves results in cupping, a characteristic appearance of the optic disc and visual loss. Glaucoma can remain asymptomatic until it is severe, resulting in a high likelihood that the number of affected individuals is much higher than the number known to have it. Without adequate treatment glaucoma can progress to visual disability and eventual blindness which is irreversible. Many types of glaucoma are usually controlled with daily medical treatment consisting of eye drops lowering IOP. Some do this by reducing the amount of aqueous fluid the eye makes. Others reduce pressure by helping aqueous fluid flow better through the drainage angle. A generic medicine is defined as a product having the same qualitative and quantitative composition in active ingredients, as well as the same pharmaceutical form, as the reference medicine and whose bioequivalence has been shown by adequate bioavailability studies, also its low price makes it more affordable.

Aim of the Work
To evaluate intra ocular pressure control and compliance of the patient using a generic prostaglandins eye drops in comparison to a brand one in the management of glaucoma patients and its safety profile, to determine the value of the generic drug in glaucoma management.

Patients and Methods
This is a prospective interventional cross over study was done on 30 patients recruited from Glaucoma Clinic of National Eye Center, Rod El Farag from January 2019 to July 2019.

Results
The mean baseline IOP of both main groups on day 0 was 23.9 ± 3.3 mmHg at 9 AM, 23.6 ± 2.7 mmHg at 1 PM, 23.6 ± 2.3 mmHg at 6 PM before treatment with original or generic latanoprost (P = 1). Both treatments reduced the IOP from baseline (day 0 of each drug) at each time-point, and for the three diurnal IOP measurements at 3 months. Original latanoprost had a greater efficacy than generic latanoprost after 3 months, Original Latanoprost reduced the IOP after 3 months of treatment by -8.6 ± 0.84 mmHg at 9.00 AM, 7.4 ± 1.2 mmHg at 1.00 PM hours and -6.4 ± 1.8 mmHg at 6.00 PM, While Generic latanoprost reduced IOP after 3 months by -7.03 ± 0.95, -5.8 ± 1.1 and -4.9 ± 1.8 mmHg, respectively.

Conclusion
Original latanoprost has a tendency of better efficacy and tolerability with low incidence of conjunctival hyperaemia and ocular irritation compared with the generic latanoprost in management of open angle glaucoma patient.
Ocular Response Analyzer versus Goldmann Applanation Tonometer for Measurement of Intra-Ocular Pressure
Authors: Fayez Rim Raafat , Abdelshafik Mohamed Adel , Aboulenain Ahmed Ibrahim , Hamdi Momen Mahmoud 
Published: October 2021

Abstract

Background
Goldmann applanation tonometry (GAT) has been the gold standard for intraocular pressure(IOP) measurement ,since its appearance in clinical practice around 50 years ago.(1) In spite of being almost unchallenged, the last few years have become a sustained search for a new standard method for IOP measurement,. One such recently marketed instrument is the Ocular Response Analyzer (ORA), which able to detect the corneal biomechanics.

Aim of the Work
is to compare the IOP measurement estimated by Goldmann applanation tonometer to that of ORA and detect the effect of state of refraction, corneal topography and central corneal thickness (CCT) on these measurements.

Patients and Methods
This cross-sectional study was done from March 2018 to October 2018 on 65 eyes of patients visiting the outpatient clinic.

Results
The mean GAT IOP was 15.938 ± 6.041 while the mean ORA (IOPcc) and (IOPg) were 19.711 ± 7.59 and 17.242 ± 7.35 mm Hg respectively. There is a strong positive relationship between GAT IOP & ORA IOPg measurement (r = 0.880 – p = &lt;0.001*). Also finding a weak yet significant correlation between IOPg and CCT (r = 0.385, p = 0.001). None of the pressure measurements was affected by refraction or corneal curvature significantly.

Conclusion
In conclusion, our results suggest that mean IOPs obtained by ORA were significantly higher than that of GAT with different influencing factors that are not completely understood. caution has to be sought when using the ORA, the values obtained ought not to be used interchangeably with the values obtained by
1 GAT, despite the presence of a positive correlation between these values. This underlines the importance of using one and only method of evaluation of the IOP for every patient in successive follow-up visits.
Safety and Efficacy of Day Case Tubeless Percutaneous Nephrolithotomy
Authors: Adel Mourad Mohamed Sherif , Mousa Waleed Elsayed , Abdelhameed Ahmed Himdan 
Published: October 2021

Abstract

Objective
to determine the outcome of day cases tubeless PCNL with only 12 hours hospital stay regarding vital data, postoperative bleeding and pain.

Materials and Methods
We prospectively reviewed 50 patients presenting to our university hospital with renal pelvic radioopaque stones less than 2 cm underwent tubeless PCNL discharged within 12 hours postoperatively. Operation time ,Occurrence of intraoperative complications and Post operative vital data , hemoglobin level were recorded

Results
All 50 patient ,16 female ,34 male patient underwent totally tubeless PCNL , intraoperatively , the operation time ranging from 45 to 85 minutes . postoperatively , the study revealed that 3 patients were found hypotensive( 6%), fever more than 38 degree occurred in 7 patients (14%) . Hemoglobin level dropped more than 1gm/dl in only 4 patients 8% , blood transfusion needed in only 2 patients , hospital readmission was needed by 7 patients (14%) within 1 week postoperatively. Outpatient follow up of the patients underwent daycase PCNL revealed that 39 patient returned to normal activities within 4 days (78%) but 11 patients took 4-7 days( 12%)

Conclusions
Tubeless PCNL is safe, feasible, and less morbid alternative to classic PCNL . decreased period of hospital stay , rapid return to normal social activities decreasing the economic burden regarding person and society.
Comparative Study between Percutaneous Approach and Transurethral Approach for Treatment of Urinary Bladder Stones
Authors: Taema Khaled , Awady Hossam Mohammed El , Mohammed El Shahawy Mahmoud 
Published: October 2021

Abstract

Purpose
The aim of this study is to compare outcome of percutaneous cystolithotripsy approach (pccl) vs transurethral cystolithotripsy approach (tucl) in treatment of large urinary bladder stones regarding efficacy, safety and peri-operative complications.

Methods
This study included 60 patients who had urinary bladder stone, treated at Ain Shams University hospitals in Egypt from March 2019 to March 2020 and randomly assigned into two groups: group A: percutaneous cystolithotripsy (PCCL) and group B: transurethral using nephroscope combined with meurmayer stone punch (tucl). Baseline and perioperative data were recorded and compared between two groups.

Results
Baseline parameters and the peri-operative complications (fever, transient haematuria, urinary bladder perforation, suprapubic wound infection and persistent leakage from suprapubic site) were compared between the two groups. Complete stone clearance was achieved in all the patients. The mean operative time in pccl group and tucl group was (30±7 min and 32±7 min) respectively. Urinary catheter duration in Pccl group was significantly more than Tucl group. Till the last follow-up, 6.6% patients (n = 2) developed urethral stricture in Tucl group.

Conclusions
PCCL is a safe procedure with acceptable morbidity and can be used as an alternative to tucl in treating (2-4 cm) urinary bladder stones.
Fecal screening of Dientamoeba fragilis: relative efficacy of permanent smear and culture
Authors: Abou-Gamra Maha M , Tawfik Rania A , Alkady Sara F 
Published: October 2021

Abstract

Dientamoeba fragilis (D. fragilis) is an enteric trichmonad protozoan parasite that remains obscure and neglected. The aim of this study is to detect D. fragilis as a neglected pathogen in children aged 6-12 years old complaining of gastrointestinal illness by stool culture and light microscopy with comparison between the results of both techniques. A total of 100 fresh stool samples were included in this current study. All specimens were subjected to microscopic examination using iron- hematoxylin stained stool smears and stool culture using a Loeffler’s culture medium. Culture detected 2 positive stool samples (2%) while microscopy detected (1%). Sensitivities of culture and microscopy were 100% and 50% respectively. Specificity of culture and microscopy were 100% and 95% respectively. There is a moderate agreement between culture and microscopy (K = 0.4). In conclusion, culture had a high performance compared to microscopy in the diagnosis of D. fragilis infection. Culture can be applied for routine diagnosis for the detection of D. fragilis in clinical samples.
Impact of Congenital Heart Disease on Growth of Down Syndrome Children (6-36 months)
Authors: Kotby Alyaa A , El Guindy Waleed M , Eissa Deena Samir M , Hussain Abeer Mohammed H 
Published: October 2021

Abstract

Background
Down syndrome (DS), the most common chromosomal abnormality is associated by congenital heart disease (CHD) in (44%) of cases. Children with DS might have different growth pattern compared to children without DS.

Objective
To assess the impact of congenital heart disease on the growth of Down syndrome children who attend the Genetic clinic, Children’s Hospital, Ain Shams University.

Materials and Methods
This case controlled study was conducted on 40 children with DS aged 6-36 months and compared to 40 age and sex matched healthy children. The DS children were divided in to two groups, the Cardiac Group: Included 20 DS children with CHD, Non Cardiac Group: 20 DS children without CHD. All children enrolled in the study were subjected to detailed history, thorough clinical examination including (anthropometric measurements (weight, height and HC) and cardiac examination.

Results
A statistically highly significant decrease was found in children with DS in comparison to normal children in all evaluated anthropometric measurements (P = 0.000) for weight, height, WT/length SDS, head circumference and Z-scores (weight, height and HC).A statistically highly significant decrease was found in DS children with congenital heart disease (cardiac group) in comparison with DS children without congenital heart disease (non-cardiac group) as regards weight (P = 0.002), Height (P = 0.000), head circumference (P = 0.000), Zscores (weight) (P = 0.001) and WT/length SDS (P = 0.001).

Conclusion
Children with trisomy 21 have well documented growth retardation. Congenital heart diseases have a negative influence on growth pattern in children with DS.
The effect of Head Covering on Phototherapy-Induced Hypocalcemia in Jaundiced Full-Term Neonates
Authors: Mohamed Amira Said , Abd El fattah Sherein M , Imam Safaa S , Shehata Basma M 
Published: October 2021

Abstract

Background
Phototherapy is the main method used in treatment of significant indirect hyperbilirubinemia and it reduces the risk of exchange transfusion. Hypocalcemia is one of the side effects of phototherapy due to inhibition of pineal gland via transcranial illumination, resulting in decline of melatonin secretion that further inhibits the effect of cortisol on bone calcium and ultimately increase the bone uptake.

Aim
To assess the effect of head covering to ameliorate hypocalcemic effect of different types of phototherapy in full term jaundiced neonates.

Patients and Methods
A prospective randomized controlled study that included 120 jaundiced neonates requiring phototherapy which divided into two main groups; group I (treated with lamp phototherapy) which was equally subdivided into two groups, group A (without head cover) and group B (with head cover) and group Il (treated with LED phototherapy) which was equally subdivided into group C (without head cover) and group D (with head cover).

Results
Head cover reduced the incidence of phototherapy induced hypocalcemia without affecting rate of decline of bilirubin on both types of phototherapy used. In lamp hypocalcemia (&lt;8mg/dl) was detected in 33.3% in jaundiced neonates without head cover which was significant higher than those with head cover 6.7%. As for LED, yet not statistically significant hypocalcemia was detected in 13.3% in jaundiced neonates without head cover, which was higher than those with head cover 3.3%.

Conclusion
Incidence of phototherapy induced hypocalcemia is reduced by using head cover especially while using lamp phototherapy.
A study of heated, humidified high flow nasal cannula as an initial respiratory support in preterm neonates
Authors: Awad Hesham A , El-Farrash Rania A , Shinkar Dina M , Aly Yasmin A. F , Soliman Nanies , Alhassanin Arwa H.A 
Published: October 2021

Abstract

Background
There is an increased use of heated, humidified, high-flow nasal cannula (HHFNC) as a non-invasive respiratory support. Yet, there are limited data that compares it with nasal continuous positive airway pressure (nCPAP) as regard the efficacy & outcome when used for initial treatment in preterm infants with respiratory distress syndrome (RDS) shortly postnatal.

Method
A prospective study conducted aiming to evaluate the effectiveness & outcome of HHFNC compared to nCPAP for the treatment of preterm infants with RDS. Preterms &lt; 35 weeks of gestational age with symptoms and signs of RDS early after birth were randomized to HHFNC or nCPAP. Primary outcome was the incidence of treatment failure (defined as need for upgrading to noninvasive positive pressure ventilation or invasive ventilation).

Results
Analysis of the randomly allocated infants to HHFNC and nCPAP showed no significant difference in treatment failure (P &gt; 0.05). There was also no significant difference (P &gt; 0.05) among groups as regard mortality, sepsis, necrotizing enterocolitis, incidence of interventricular hemorrhage and bronchopulmonary dysplasia.

Conclusion
This indicates that HHFNC may be used as an equally effective and safe method of non-invasive ventilation when compared to nCPAP for initial respiratory support in preterm infants with respiratory distress.