bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perineural versus Systemic Dexamethasone to Prolong Analgesia after ultrasound guided Inter-Scalene Brachial Plexsus Block in Arthroscopic Shoulder Surgeries
Authors: AbdelHalem Sarah Amr Abbas , Fahmy Adel Mekhail , El Fawy Dalia Mahmoud , ElFar Marwa Mamdouh Mohamed 
Published: October 2021

Abstract

Background
Poorly controlled acute pain after surgery is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stay and increase of chronic pain. Neuraxial block is used for postoperative pain management and decrease analgesic use.

Objective
To compare the analgesic duration of intravenous and perineural administration of Dexamethasone in interscalene block during arthroscopic shoulder surgery.

Patients and Methods
Interventional randomized Double-Blind Study. This study was conducted in Ain Shams University Hospitals’ operating rooms throughout six months. In our study, 60 patients were randomly divided into two equal groups:

Group A (30 patients)
Block with 20 ml Bupivacaine 0.5% (+ 2 ml Dexamethasone ‘8 mg’) & 5 ml normal saline was injected IV.

Group B (30 patients)
Block with 20 ml Bupivacaine 0.5% (+ 2 ml normal saline) & 5 ml Dexamethasone ‘8 mg’ was injected IV.

Results
Our study showed that addition of 8 mg dexamethasone to bupivacaine in interscalene brachial plexus nerve block prolongs post-operative analgesia & reduced numbers of rescue analgesia doses more than injecting dexamethasone intravenously.

Conclusion
Addition of perineural dexamethasone to bupivacaine in interscalene brachial nerve block prolongs post-operative analgesia & reduced numbers of rescue analgesia doses more than injecting dexamethasone intravenously. Dexamethasone was seen to be a potent adjunct to local anaesthetic to prolong post-operative analgesia with negligible side effects.
Outcome of surgical repair of Stanford type A aortic dissection in elderly patients: a contemporary systematic review and meta-analysis
Authors: El-Galb Hani Abd El-Maabood Metwlly , Amar Ayman Mahmoud Amin , Abd El-Gawad Mohamed Nabil Mohamed , El-Kholey Mohamed Ibrahim Reiad 
Published: October 2021

Abstract

Background
The results of surgical treatment of type A aortic dissection (AAD) in the elderly are controversial and aggravated by a higher operative mortality rate. The studies published in this subset of patients are mainly retrospective analyses or small samples from international registries. We sought to investigate this topic by conducting a contemporary meta-analysis of the most recent observational studies.

Methods
A systematic literature search was conducted for any study published from the inception till August 2019 on aortic dissection treated surgically in patients 70 years and older. A pooled risk-ratio meta-analysis has been conducted three main post-operative outcomes: short-term mortality, stroke and acute kidney injury.

Results
A total of 23 retrospective observational studies have been included in the metaanalysis. Pooled meta-analysis showed an increased risk of short-term mortality for the elderly population [relative risk (RR) =1.39; 95% CI, 0.64–3.5; I2=92%; P &lt; 0.001], and this has been confirmed in a sub-analysis of patients 80 years and older. The risk of having stroke (RR = 1.47; 95% CI, 0.66–3.29; I2=91%; P = 0.35) and acute kidney injury (RR = 1.12; 95% CI, 0.32–3.9, I2=90%, P = 0.85) after surgery were comparable to the conservative treatment of patients.

Conclusion
Although affected by an increased risk of short-term mortality in the elderly, surgical repair remains the treatment of choice for AAD. The main post-operative outcomes are comparable to younger patients and the mid-term survival rates are acceptable.
The Added Value of ST-Elevation in Lead aVR to Clinical TIMI Score in Predicting the Angiographic Severity of Coronary Artery Disease in Patients with Non ST-Elevation Myocardial Infarction
Authors: Elfahham Abobakr Fawzy , El Etriby Shehab Adel , Abdelsalam Ahmed Mohamed , Awad Omar 
Published: October 2021

Abstract

Background
Atherosclerosis is the ongoing process of plaque formation involving primarily the intima of large and medium-sized arteries. The condition progresses relentlessly throughout a person’s lifetime, before finally manifesting itself as an acute ischemic event. TIMI score is a tool of 7 points for patients with NSTE-ACS to detect the risk according to the score. The term acute coronary syndrome (ACS) includes unstable angina (UA), non STsegment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI).

Aim
To investigate the added value of the presence of ST-segment elevation in lead avR on admission electrocardiogram to the (TIMI) clinical scoring system in predicting the angiographic severity of coronary artery disease in patients admitted with NSTE-ACS.

Patients and Methods
150 patients with Non ST-segment elevation acute coronary syndrome was included from Cardiology Department, Ain Shams University Hospital, Cairo, Egypt.

Results
From those patients, 137 patients (91.3%) diagnosed by coronary angiography to have significant CAD and 93 patients (62%) had ST-Elevation in lead aVR . These 137 patients were divided into 3 groups according to TIMI risk score to 16 patients (10.6%) had low risk score, 63 patients (42.0%) had intermediate risk & lastly 58 patients (38.7%) had high risk score. . Although being useful in prediction of multi-vessel & LM involvement among high risk group, TIMI score failed to predict the same in intermediate & low risk groups where multi-vessel involvement was found in 46 patients (30.6%) & 7 patients (4.6%) of intermediate & low risk groups respectively. Also LM involvement was found in 15 patients (10%) & 2 patients (1.3%) of intermediate & low risk groups respectively.

Conclusion
ST-segment elevation (STE) in lead avR had an adding predicting value in NSTEACS patients especially those with low to intermediate TIMI score. Adding the value of STE in lead aVR to TIMI risk score may improve the early stratification & management of those patients at high risk coronary artery disease, with subsequent impact on morbidity & mortality.
Echocardiography calcium score as predictive tools of severity of coronary artery disease
Authors: Ismail Asmaa , Abdeltawab Adham , Roshdy Alaa 
Published: October 2021

Abstract

Background
Coronary artery disease (CAD) represents a leading cause of death worldwide. Coronary angiography represents the gold standard for diagnosis and selection of the best treatment for the patients with coronary artery disease; however some efforts have been made to predict CAD severity and complexity using non-invasive methods in order to identify the patients at high risk for cardiovascular events with less risk to the patients and before doing coronary angiography. Characterization of coronaryartery calcification by computed tomography known as Coronary artery calcium score (CACS) is equivalent to the total coronary atherosclerosis load and is proven to be related to angiographically significant lesions. Echocardiographic calcium score is now validated against non-coronary calcium by computed tomography with lower cost and no irradiation safety issues for reclassification of cardiac risk.

Aim and Objectives
to determine the correlation of echocardiography calcium score to severity of coronary artery disease.

Patients and Methods
Patients coming to Ain Shams University Hospitals for elective coronary angiography were subjected to histoty taking, examination, blood samples and echocardiographic examination. The echocardiographic calcium score was correlated with syntax score of their coronary angiography films. Also syntax score was divided into three groups; low risk ≤ 18, intermediate risk 18-27 and high risk groups &gt;27.

Results
The study included 45 patients; 21 of which were males representing 46.6% of the participants. The mean age of the whole group was 52.7 ± 8.18. The mean final calcium score of the whole study group was 4.95±1.29. The mean syntax score of the whole study group was 22.88±12.3. There was significant difference between the three subgroups of the syntax score regarding total calcium score (p value 0.013) and highly significant difference between the numerical values of syntax score and final calcium score.

Conclusion
Echocardiographic calcium score is correlated to syntax score and the severity of coronary artery disease. The low cost, availability and the radiation free nature of echocardiography make it an attractive candidate for the on-going research regarding the non-invasive tools for prediction of CAD.
Single Centre Experience in Pediatric Pacing
Authors: Arafa Hosny , Ali Ahmed N , Ahmed Rania S , Wafa Samir S 
Published: October 2021

Abstract

Corresponding author
hosnihosni5627@gmail.com ( Hosny Hosny Elsayed Arafa)

Background
Permanent Pacemakers have a growing use in the pediatric population due to congenital and surgically acquired rhythm disturbances but they present unique problems and implications. Their implantation, follow up, the diversity and complexity of pediatric patients and congenital heart disease make device management a highly individualized art in pediatric pacing. Certain challenges are posed in adult-like somatic growth and active lifestyle susceptibility to infection and generally anticipated long survival.

Objective
The current study aims to present our institute's experience in pediatric and adolescent pacemaker implantation and long term outcome.

Patients and Methods
The study included 100 patients who have cardiac devices (permanent pacemaker)that were implanted in AinShams University and visit our patient clinic for regular programming during the period from July 2018 to December 2019. All patients were subjected to history taking, clinical examination, ECG recording then Echocardiography and device programming.

Results
The study included 100 patients,49 females and 51 males with a mean age of 13.12 ± 5.04. Patients weighted from 8 to 85 kg, measured from 40 to 185 cm in height. According to the mode of pacing, 67 were in the VVIR group while 33 in the DDDR group. According to the indication of pacing, two cases were due to sinus node dysfunction,52 due to congenital complete heart block and 46 due to postoperative CHB. 59 patients underwent cardiac surgery. 53 were admitted to CCU by syncope or presyncope. As Regards the complications,2 cases had superficial infection after 2 weeks relived by antibiotic, 2 patients suffered from pocket hematoma after 2 weeks, 10 cases of lead fracture from 1 to 8 years after implantation due to external trauma, 3 cases of lead dislodgment from 1 to 6 months postprocedure,1 case developed LV dysfunction and upgraded to CRT,1 case had psychological trauma and 3 cases had insulation breaks. The device with the longest longevity duration is Medtronic and Tendril leads had the most common complications.

Conclusion
Implantation of a pacemaker in children is generally safe. It could be justified to implant the pacemaker to improve the hemodynamic situation in individual patients or to consider biventricular pacing in LV dysfunctiont
Hybrid Technique for Acute on chronic Lower Limb Ischemia, A single centre study
Authors: Mohammed Islam Badry , Kamel Amr Nabil , Zaki Mohammed Mahmoud 
Published: October 2021

Abstract

Background
Several methods have been postulated for the treatment of acute on chronic lower limb ischemia; among them, the hybrid procedure (combined open thrombectomy and angioplasty) is gaining popularity .It is aimed at clearing the vessel and treating the underlying vessel lesion in one step.

Patients and Methods
A total of 23 patients admitted to the vascular department were eligible for inclusion in this study. They were subjected to thromboembolectomy, followed by endovascular balloon dilatation with or without stenting. Data regarding the risk factors, procedure success, and complications were recorded.

Results
Hybrid procedures showed 91.6% immediate technical success and 82.6% primary limb salvage rate up to 6 months with accepted minor complications. and no major complications

Conclusion
The hybrid procedure provides an accepted outcome in treating immediately limb- threatening acute on chronic lower limb ischemia.
Assessment of the Oxidative Stress Status in Androgenetic Alopecia in Egyptian Men
Authors: Diab Heba Mahmoud , Soltan Marwa Yassin , El-Khazragy Nashwa , Atef Raafat Aliaa Mohamed 
Published: October 2021

Abstract

Background
Androgenetic alopecia (AGA) is the most common type of hair loss in men. It is commonly known as a male pattern baldness. It is characterized by a stepwise miniaturization of the hair follicle, resulting from alteration in the hair cycle dynamics, leading to vellus transformation of terminal hair follicle. In AGA, the duration of anagen phase gradually decreases and that of telogen phase increases, the maximum length of the new anagen hair becomes shorter than that of its predecessor, leading to miniaturization and eventually a bald appearance.

Aim of the Work
To assess the expression of NRF2 in the scalp of men with androgenetic alopecia.

Patients and Methods
This case control study included 28 male patients whose age ranged from 18 to 45 years old. They were diagnosed as having AGA according to Norwood-Hamilton scale. Further, 28 age and sex matched healthy male controls were recruited. All patients and controls were recruited from the dermatology outpatient clinic of Ain-Shams University Hospitals, during the period of September 2018 to April 2019.

Results
A group of Twenty-eight male patients with AGA were recruited to the study. The of patients ranged from 18 to 45 years (mean = 33.46 years ± 9.9 SD). Twenty-eight age matched male healthy volunteers without AGA were e recruited. The majority of AGA patients had positive family history of AGA in their first degree relatives. None of our patients had a medical history of systemic diseases like diabetes mellitus or hypertension.

Conclusion
The current study showed that alteration of Nrf2 levels may play an important role in the pathogenesis of AGA.
Assessment of Calprotectin in blood and tissue of Acne Vulgaris patients of different clinical severities
Authors: Mohamed Ghada Fathy , fattah Afify Ahmed Abdel , hady Ahmed Waleed Abdel , Elsayed Eid Basant Alaa Eldin Elsayed Mohamed 
Published: October 2021

Abstract

Background
Acne vulgaris is a multifactorial inflammatory skin disease of the pilosebaceous unit with complex pathogenesis. Calprotectin is a heterodimer of two calcium-binding proteins S100A8 and S100A9, which are members of the S100 protein family, and which play a role in various inflammatory processes, it is mainly present in the cytoplasm of neutrophils and expressed on the membrane of monocytes.

Objective
to assess the level of Calprotectin in blood and in tissue of AV patients and compare it with healthy controls. Beside correlate it with the degrees of severity of acne in order to further understand the role of Calprotectin in the pathogenesis of AV.

Subjects and Methods
This case-control study included 28 subjects who have AV, divided into four groups according to Global Acne Grading System: the first group included 7 patients with mild acne, the second group included 7 patients with moderate acne, the third group included 7 patients with severe acne, and the fourth group included 7 patients with very severe AV. In addition to a control group which included 28 apparently healthy individuals of matched age, sex and with no previous history of acne or active acne. All the patients were recruited from the outpatient clinic of Al Haud Al Marsoud hospital from September 2019 till January 2020. After taking the approval of research ethics committee (FMASU M S 22/2019) all subjects gave an informed consent to participate in this work.

Results
Our study showed that the increase in AV severity was not affected by the difference in gender, type of acne, nor disease duration. However, there was a significant correlation between plasma calprotectin level and AV severity. In addition to, There was a significant statistical correlation between the increase in the age of patients and the decrease in the severity of acne, which indicates that AV is more severe in younger patients than older ones. The correlation between the Plasma Calprotectin level in patients group and Tissue Calprotectin level in inflammatory lesions (papules) was non-significant. However, the correlation between the Plasma Calprotectin level in patients’ group and Tissue Calprotectin level in non-inflammatory lesions (comedones) was highly significant.

Conclusion
Plasma Calprotectin level showed significant relation with AV severity and presence of scar. The correlation between plasma Calprotectin level and tissue Calprotectin level in noninflammatory lesions (comedones) was highly significant.
A Split Scalp Study of Single versus Double Spin Platelet-rich plasma Injections in Treatment of Female Pattern Hair Loss: Clinical Effect and Relation to Vascular Endothelial Growth Factor in PRP
Authors: Salem Samar A , Elhusseiny Rania M , Saleh Haitham M 
Published: October 2021

Abstract

Background
Female pattern hair loss (FPHL) is the most common hair loss disorder in women. Platelet-rich plasma (PRP) provides an option for patients recalcitrant to the currently approved therapies. As there are many methods for the preparation of PRP, the most suitable for AGA therapy is not yet clear.

Aims
To compare the efficacy between single and double spin PRP injections in treatment of FPHL and to assess the relationship between the concentrations of vascular endothelial growth factor (VEGF) in the PRP preparation and the treatment results obtained.

Patients and Methods
15 female patients with FPHL were enrolled. Each patient was subjected to intradermal injection of PRP (prepared by double-spin method) into the right half of the scalp, in addition to intradermal injection of PRP (prepared by singlespin method) into the left half of the scalp in the form of three treatment sessions three weeks apart. Evaluation of treatment response was done through comparing patients' global photographs, assessment of patients' satisfaction and folliscopic assessment before and after treatment.

Results
Our results showed clinically significant improvement by comparing patients' photographs in most of the treated patients. In addition, folliscopy revealed significant change of the terminal hair density in the right half of the scalp following treatment sessions.VEGF concentration didn't differ significantly between double-spin and single-spin prepared PRP, also it didn't differ significantly upon calcium activation.

Conclusions
PRP is an effective treatment modality for FPHL. Double-spin prepared PRP could yield better results in the treatment of FPHL than the single-spin method. However, adding Calcium gluconate prior to PRP injection is of no benefit as it didn't significantly increase the release of VEGF. Yet, further studies discussing different PRP preparation protocols and involving a larger number of cases are needed to minimize statistical errors and to detect the most accurate PRP preparation method with the greatest yield of growth factors.
Evaluation of the Efficacy of Intense Pulsed Light in Skin Rejuvenation
Authors: Mohammad Meram Adel , El-Husseiny Rania Mahmoud , Elsamahy May Hussein 
Published: October 2021

Abstract

Background
The pathology of skin aging is a very complex process. There are extrinsic and intrinsic factors which contribute to the pathogenesis of skin aging. Intrinsic (chronological) aging is caused by inherited genes, and extrinsic aging caused by many external factors such as exposure to the sun. With increasing age, more people are seeking to maintain the health of their skin and the demand for treatment of aged skin has raised.(1)

Aim of the Work
To evaluate the efficacy of Intense Pulsed Light in skin rejuvenation with assessment by antera 3D camera.

Patients and Methods
This study is a single arm interventional study which included 21adult housewives female patients complaining of different signs of facial photodamage, their age ranged between 30 -40 years, recruited from outpatient dermatology clinic of Ain Shams University Hospital, from June 2018 to January 2019. Patients were subjected to 4 sessions of IPL treatments 2 weeks apart for skin rejuvenation. Evaluation of treatment response was done through Global Aesthetic Improvement Scale (GAIS), Antera 3D camera and patient satisfaction score.

Results
There was highly significant decrease in indentation index of wrinkles, roughness index of skin and average level of melanin (average of whole face) measured by Antera 3D camera after last IPL treatment session (p value=0.001).

Conclusion
IPL is proven to be safe and elicited a significant skin rejuvenating effect without prolonged downtime.It is effective in treating various manifestations of photodamaged skin, as consistently enchoed by patient satisfaction scores, GAIS and Antera 3D camera results.
Efficacy and Tolerability of N-Acetyl-Cysteine for Treatment of The Early-onset Androgenetic Alopecia in Men
Authors: El Sayed Mahira Hamdy , Soltan Marwa Yassin , Sadek Ahmed , Hussein Mohamed Mohamed Abo Shabana 
Published: October 2021

Abstract

Background
Androgenetic alopecia (AGA), the most common form of hair loss in men, involves the progressive loss of visible pigmented terminal hair on the scalp in response to circulating androgens. AGA is an autosomal disorder which begins in puberty in genetically predisposed individuals.

Aim of the Work
To study the effectiveness and safety of the reactive oxygen species scavenger Nacetyl-cysteine (NAC) as a single therapy and in combination with the topically applied minoxidil for treatment of the early-onset androgenetic alopecia in men.

Patients and Methods
The present study included 100 patients with male pattern hair loss whose age ranged from 18 to 30 years old, recruited from dermatology clinics in Ain Shams University Hospital and Kafr El Sheik University Hospital.

Results
Overall, all treatments could improve significantly some of the trichoscopic parameters as compared to the control group who did not receive any treatment. The number of terminal hair count increased and the vellus hair count decreased in response to either of treatments; minoxidil, NAC, or both as compared to control. These changes were noticed at both the vertex and frontotemporal sites. The treatment was generally tolerable and the side effects encountered did not necessitate stoppage of the treatment course.

Conclusion
On the basis of the findings of current study we can conclude that, the role of trichoscopy in increasing the accuracy for diagnosing hair disorders as well as to detect response or failure to treatment, N-acetylcysteine (NAC) improved significantly most of the trichoscopic features of AGA and it was was generally tolerable and the side effects encountered did not necessitate stoppage of the treatment course.