bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative assessment of macular and peripapillary microvasculature using optical coherence tomography angiography in glaucomatous versus healthy eyes
Authors: Sanad Amr M , Mahgoub Mohamed M , Ebeid Weam M , Mahmoud Rabab A 
Published: October 2021

Abstract

Background
Glaucoma is the leading cause of irreversible blindness worldwide. With the growing burden of glaucoma, we looked for better tools for early diagnosis and monitoring.

Aim of the Work
using optical coherence tomography angiography (OCTA) vessel density (VD) to document, quantify and compare microvasculature changes in macula and peripapillary region between healthy and moderate to severe primary open angle glaucoma eyes.

Patients and Methods
A comparative interventional prospective study was conducted on 28 eyes of 14 subjects, recruited from Ain Shams University hospitals outpatient clinic, and were subjected to imaging procedure during the period from January 2020 to May 2020. Subjects were divided into two groups: Group 1 of 14 eyes of 9 patients with moderate to severe primary open angle glaucoma (POAG), and group 2 of 14 eyes of 7 healthy sex and age-matched controls.

Results
a statistically significant decrease was found in VD in the peripapillary region (P &lt; 0.001) and superficial macular regions in glaucoma subjects (P &lt; 0.001).

Conclusion
OCTA proved a quantitative decrease in both peripapillary and macular vessel density as a parameter of microvascular changes associated with moderate to severe POAG. These results reflect damage to tissues relevant to the pathophysiology of POAG demonstrating OCTA importance with respect to diagnosing glaucoma and understanding the pathophysiology of this disease and, guiding future studies to evaluate more potential uses of this technology in the actual assessment of patients with glaucoma.
Optical Coherence Tomography Angiography Features In Diabetic Patients With Unexplained Visual Loss
Authors: Ibrahiem Enas Ibrahiem Abdallah , Ebeid Weam Mohamed Ahmed , Abozeid Noureldin Hussein , Salman Abd AL Rahman Gaber 
Published: October 2021

Abstract

Background
Diabetic macular ischemia (DMI) has a conflicting impact on visual loss in diabetics. OCTA used as a new non-invasive technique allows for identification of several anatomical and vascular abnormalities of diabetic maculopathy.

Aim
This study aimed to detect quantitative and qualitative OCTA data of Foveal area in diabetic patients with unexplained visual loss.

Methods and Material
This cross-sectional study enrolled fifteen diabetic patients with unexplained visual loss. They underwent comprehensive ophthalmological assessment, Measurement Best-Corrected Visual acuity (BCVA) using a Snellen chart converted to LogMAR for statistical analysis. And OCTA imaging of the foveal area using AngioVue OCTA. Quantitative data analysed was Foveal Avascular Zone (FAZ) area.

Statistical analysis used
Descriptive statistics and Pearson correlation were performed.

Results
A positive significant correlation was noted between LogMAR BCVA and FAZ area (p = 0.004). DMI grade showed significant positive correlation with LogMAR BCVA (p = 0.011).

Conclusions
The current study demonstrated the significant correlation between FAZ area measured by AngioVue OCTA and BCVA in diabetic patients with unexplained visual loss. In addition, we elucidated Diabetic Macular Ischemia (DMI) as a leading reason for visual loss in diabetic patients by itself.
Subthreshold micropulse yellow (577nm) laser versus intravitreal Ranibizumab in treatment of center involving diabetic macular oedema
Authors: Diab Esraa Abdelhakeem , Mahmoud Alaa Fathy , Zaki Mohamed Abd el-hakim , Mohmaed Ahmed Abdel-aleem , Abdel-aziz Mohamed Hanafy 
Published: October 2021

Abstract

Purpose
To evaluate the effectiveness of subthreshold micropulse laser as compared to intravitreal injection of ranibizumab in treatment of center involving diabetic macular oedema.

Methods
A total of 76 eyes of 62 patients with center involving diabetic macular oedema were divided into two groups. Group A received intravitreal injection of ranibizumab while group B received subthreshold micropulse laser with rescue intravitreal injection of ranibizumab. The change from baseline in best correscted visual acuity and central subfield thickness were compared at 3, 6, 9 and 12 months follow-up. Any adverse effects were recorded.

Results
Group A (n = 34 eyes) experienced a statistically significant improvement in best corrected visual acuity (from 0.32±0.16 Log MAR at baseline to 0.21±0.14 Log MAR at 12 months) (P value =0.006), with a statistically significant reduction in central subfield ghickness (from 352.06±34.34µm to 289.47±58.88 µm) (P value=0.001). Group B (n = 42 eyes), also experienced a statistically significant improvement in best corrected visual acuity (from 0.34±0.22 Log MAR at baseline to 0.13±0.31 Log MAR at 12 months) (P value=0.001), with a statistically significant reduction in central subfield thickness (from 300±47.34µm to 253.12±39.60 µm at 12 months) (P value= 0.009). The mean difference in best corrected visual acuity between the group B and group A was -0.08 Log MAR with a 95% CI ranging from -0.197 to 0.037, which supports the claim of non-inferiority between the two treatment regimens. No adverse effects from subthreshold micropulse laser were recorded in both groups.

Conclusion
subthreshold micropulse laser with rescue intravitreal injection of ranibizumab was non inferior to intravitreal injection of ranibizumab in treatment of center involving diabetic macular oedema as regards the mean change in best corrected visual acuity.
Assessment of the Ocular Effects in Cardiac Catheterization Unit’s Medical Personnel Exposed to Ionizing Radiation
Authors: Abdelatty Azab Mariam Ramadan Ramadan , Mohamed Thanaa Helmy , Ebeid Weam Mohamed , Alaarag Noha Abdelsadek , Zaky Amr Mansour Mohamed , Saleh Waleed 
Published: October 2021

Abstract

Background
Gamma rays, x-rays, and high ultraviolet are classified as ionizing radiation as their photons have enough energy to ionize atoms, causing chemical reactions. People can be exposed to ionizing radiation under different circumstances, at home, in public places (public exposures), at their workplaces (occupational exposures), or in a medical setting (as are patients, caregivers, and volunteers). Radiation damage to tissue or organs depends on the dose of radiation received, or the absorbed dose which is expressed in a unit called the gray (Gy). The potential damage from an absorbed dose depends on the type of radiation and the sensitivity of different tissues and organs.

Objective
To investigate the long-term influence of the ionizing radiation on the human lens.

Patients and Methods
Type of Study: Cross-Sectional Study. Study Setting: Ain Shams University hospital, Ophthalmology Department. Study Period: 6 months. Results: A significant difference was found between groups regarding the presence of cataract.as 50% of exposed group had cataract compared to 26.9% of non-exposed group (P = 0.043). There was a significant positive correlation between exposure duration and cataract grade as it was longer in cases with cataract.

Conclusion
A significant difference was found between groups regarding the presence of cataract. As there is a risk that other ocular pathologies are related to occupational radiation exposure, further investigative studies are required to define these. It can be strongly recommended that all personnel exposed to occupational radiation have routine eye examinations.
Validation and Repeatability of Inferior minus Superior Value and its Cut-off Value in Anterior Sagittal Curvature Map Using Pentacam in Early Keratoconus
Authors: Yousef Mohammed El Sharkawy Mohammed , Elkitkat Rania Serag , Roshdy Maged Maher Salib , Eltagoury Khaled Abdel Wahab 
Published: October 2021

Abstract

Background
: Keratoconus (KC) is a bilateral asymmetric localised inferior and central corneal thinning and ectasia. Usually, it causes high myopia and irregular astigmatism resulting in a poor quality of vision. One of the most important ways of avoiding iatrogenic ectasia in cornea during refractive surgery is to detect KC in its earliest stage using the Pentacam. An important asymmetry decentration index is the inferior minus superior (IS) value.

Purpose
: Detection of Inferior minus Superior (IS) value and its Cut-off Value

Methods
: This is a cross-sectional, case control study that included 92 right eyes of 92 subjects, who presented to the outpatient clinic of “Al Watany Eye Hospitals” seeking refractive surgery or routine medical consultations. Our study focused on the measurement of the IS-value in early KC (TKC grade 1 and FFKC) and normal eyes. The right eye of each candidate was scanned 5 times in the same setting using the Pentacam. The study adhered to the tenets of the Declaration of Helsinki, and an approval was obtained from the ethical committee of Ain Shams University Hospitals.

Results
: We detected remarkably high statistically significant difference between patients and controls regarding the IS-value (p &lt; 0.001). The mean (±SD) of control and cases group was 0.3 ± 0.2 and 1.4 ± 0.6, respectively. The cut-off point of 0.69 with high area under the receiver operating characteristic (AUROC). Coefficient of variation median (95% CI) for cases and controls were 1.4% (0.9 to 3.1%) and 6.2% (3 to 9.4%), respectively.

Conclusion
: The IS-value has a high repeatability and AUROC for differentiating early KC from normal corneas. It can be regarded as an accurate parameter for early KC detection.
The Relation between Vitamin D Levels and Cardiovascular Comorbidities in Obese Children
Authors: Elsedfy Heba Hassan , Amr Nermine Hussein , Mostafa Shereen Mohamed , Emam Abeer Mohamed 
Published: October 2021

Abstract

Background
Childhood obesity is accompanied by increased cardiovascular co morbidities and vitamin D deficiency. However, the relation between vitamin D deficiency and cardiovascular comorbidities remains uncertain.

Objectives
We aim to determine if there is an association between vitamin D deficiency and cardiovascular risks in obese children.

Patients and Methods
A case control study was conducted on 63 prepubertal patients with simple obesity recruited from the pediatric obesity clinic, Ain Shams University. They were divided into 2 groups: 33 cases with deficient 25(OH) D (&lt; 20ng/ml) and 30 with sufficient 25(OH) D (≥ 20ng/ml). Both groups were subjected to full history taking, general examination including blood pressure, anthropometric measurements and laboratory evaluation including lipid profile, thyroid profile and glucose homeostasis parameters.

Results
There was a positive correlation between 25(OH) D and HDL cholesterol (r = 0.407, p = 0.026). Obese children with deficient 25(OH) D had significantly higher diastolic blood pressure percentiles (86.20 ±9.20 in deficient vs 78.44±15.50 in sufficient, p = 0.018).

Conclusion
A possible relationship exists between obesity related comorbidities and vitamin D status. Further studies should focus on the effect of vitamin D deficiency on obesity related comorbidities.
Effect of very early use of caffeine citrate in preterm neonates needing respiratory support
Authors: Awad Hisham A , Tawfik ameh A , Ibrahim Mariam JA , Hesham Bassem 
Published: October 2021

Abstract

Background
Caffeine citrate is one of the most widely used medications in neonatal intensive care units. It is a respiratory stimulant which has well established therapeutic effects in apnea and extubation. Little is known about the very early use of caffeine citrate in preterm neonates. We aim to explore the effectiveness of its very early use in reducing the duration of the respiratory support used and not just extubation.

Objectives
to study the effect of the very early use of caffeine citrate in preterm neonates on morbidity and short-term neonatal outcomes.

Subjects and Methods
A prospective phase 3 clinical trial was carried out on 54 preterm neonates less than 34 weeks of gestation who require respiratory support and were given caffeine citrate in two different settings, over a period of one year. Patients were randomly allocated to one of two groups, the first group was given caffeine citrate at initiation of respiratory support(CPAP, NIPPV and IPPV). The second group received caffeine citrate 6 hours before weaning of the respiratory support used. Caffeine citrate was stopped after complete removal of the respiratory support used. Both groups were compared as regard the duration of each respiratory support used separately and the total duration of respiratory support needed for each patient.

Results
The duration of IPPV used in patients was significantly lower in the patients that received early caffeine citrate. Total duration of the respiratory support needed for each patient was significantly lower in the early group. There was no significant difference in the development of complications related to the drug use between both groups. The total duration of NICU stay was significantly lower in the early group than the other group.

Conclusion
The Early initiation of caffeine citrate has effectively and safely decreased duration of respiratory support used and NICU stay without the development of any complications.

Key words
early caffeine citrate, preterm neonates, respiratory support.
*CPAP: Continuous positive airway pressure
NIPPV: Non invasive positive pressure ventilation
IPPV: Intermittent positive pressure ventilation
NICU: Neonatal Intensive care unit
Assessment of Mother-to-Child transmission of Hepatitis C Virus in Egyptian Pregnant Women
Authors: El-Sayed Manal Hamdy , Ebeid Fatma Soliman Elsayed , El-Din Aya Mostafa Kamal , Mostafa Rania Hassan , El-Monem Mohammed Belal Khaled Abd 
Published: October 2021

Abstract

Background
The World Health Organization (WHO) has an ambitious plan to eliminate HCV by 2030. This new approach was fueled by increased appreciation of the global morbidity and mortality caused by hepatitis C, and the remarkable recent treatment developments.

Objectives
To assess the mother-to-child transmission of hepatitis C virus in Egyptian pregnant women to inform on screening policies and strategy development. To measure prevelance of hepatitis C virus infection in pregnant women

Methods
The current study was conducted to six thousand and seven hundred and thirty four (6734) women delivered in El Demerdash Maternity Hospital in the period from January 2018 till June 2018. Collection of detailed data from Patients files and divided them into non screened and screened by antibodies and who do PCR for HCV and data of their neonatal outcome

Results
Comparison according to HCV PCR regarding labor characteristics show that cases with positive HCV PCR significantly had more frequent CS. Logistic regression for risk factors for HCV PCR among the studied cases show that only Previous hospitalization and previous transfusion were significant risk factors for positive HCV PCR.

Conclusion
Previous hospitalization and previous transfusion were significant risk factors for positive HCV PCR. Pregnants with positive HCV PCR significantly had more lower hemoglobin than non-infected pregnant one and previous abortion and hospitalization may play a role in that.
Clinico-radiological Profile in Children with Drug Resistant Focal Epilepsy
Authors: Younis Neveen Tawakol , Mohammed Shaymaa Abdel Sattar , Zaitoun Raghda Mohamed Hesham , Shokdef Mohammed Atia Abdel Hafez 
Published: October 2021

Abstract

Objective
To assess the clinical and neuroimaging findings of pediatric patients with drug-resistant focal epilepsy, comparing conventional MR technique to the "essential 6” protocol.

Methods
An observational study of 18 children with drug resistant focal seizures identified both clinically and/or by EEG findings. Available clinical data as well as EEG and MRI data in patients’ files at the pediatric neurology clinic at Ain Shams University was retrospectively evaluated and documented. All patients then underwent a new MRI study using a novel MR technique - the essential six sequence protocol to determine whether the latter technique was superior to standard at picking subtle anatomical abnormalities in children with drug resistant focal epilepsy.

Results
18 children (10 males and 8 females) with a mean age of 8.49 ±3.20 years were enrolled. The mean age at onset of epilepsy was 3.24 ±2.79 years. 15 out of 18 patients (83%) had an abnormal EEG. The mean Chalfont Seizure Severity Scale Score was 63.71 ±34.35. There was no statistically significant difference in Chalfont seizure severity scores between patients with normal vs abnormal EEG, and with normal vs abnormal MRI. The novel MRI technique could pick on an abnormality in 12 out of the 18 cases (66%), which is six times more than what could be identified using the baseline/conventional MRI technique.

Conclusions
The essential 6 MRI protocol is superior to conventional MRI protocols at picking structural abnormalities in patients with drug resistant focal epilepsy.
Assessment of the current practice of asthma exacerbation management in different health settings in Egypt
Authors: Salama Ashraf A , EL-Hatab Amira F , Wahdan Maha M , ElAnsary Manar M 
Published: October 2021

Abstract

Background
Asthma accounts for about one in every 250 deaths worldwide. Many of the deaths are preventable, being due to suboptimal long-term medical care and delay in obtaining help during acute exacerbation.

Aim
to assess knowledge, attitude and practice of Egyptian physicians about childhood asthma exacerbation treatment guidelines and to identify the barriers against application of guidelines in different hospital settings in Egypt.

Methods
a written questionnaire with different topics were added aiming at assessment of four important aspects about the involved physicians; physician's knowledge, practice, attitude and barriers against application of guidelines. This questionnaire was fulfilled by 200 pediatricians, all of them deal with childhood asthmatics. As regards Academic degrees, 94 (47.7%) had the Bachelor degree, 70 (35.5%) had Master degree, 23 had Diploma degree (11.7%), and 10 (5.1%) had Doctorate. As regards Hospital settings, 102 (51.8%) of the pediatricians were working in governmental hospitals, 76 (%38.6) of them were working in University hospitals, 13(6.6%) pediatricians worked in private hospitals and 6 (3%) pediatricians worked in other types of hospitals.

Results
low level of knowledge was found in 80.2% of participants, non adherence to guidelines was found in 59.4 % and negative attitude towards guidelines was found in 65.3% of them.

Conclusion
Most of the studied physicians have low level of knowledge, non adherence to guidelines and negative attitude towards guidelines. The main barriers against guideline application were the external barriers followed by patient related barriers then personal barriers. Guideline related barriers were in the last rank. So, Continuous training of physicians, increasing people’s awareness and improving facilities in hospitals are required to get better adherence to guidelines
Correlation between Non-invasive Measurement of Carboxyhemoglobin and Bilirubin Level Measurement in Near- Term and Term Neonates as a Predictor of Neonatal Hemolysis
Authors: Awad Hisham A , Shehata Basma M , Fouad Marina A 
Published: October 2021

Abstract

Background
Neonatal hyperbilirubinemia is common in the neonatal period. Yet, serious pathological hyperbilirubinemia may cause kernicterus with detrimental neurologic sequalae. Carbon monoxide (CO) is the byproduct of the breakdown of heme, it is transported as carboxyhemoglobin to the lungs to be exhaled. Thus, carboxyhemoglobin levels increase as a result of hemolysis, and is therefore considered a sensitive index for the degree and severity of the subsequent hyperbilirubinemia.

Objectives
To correlate between non-invasive carboxyhemoglobin levels and bilirubin levels in near-term and tem neonates starting hour I of life.

Subjects and methods
A total of 100 near-term and term neonates were studied, by measuring carboxyhemoglobin by a Pulse CO-oximetry and serum bilirubin level (hour l) and transcutaneous bilirubin (TcB) hourly since birth for the I st 6 hours then every 6 hours till the time of discharge in a cross sectional case-control study.

Results
A cut off value of 4 for non-invasive carboxyhemoglobin with sensitivity of 81.25%, specificity of 95.24% was found to the earliest non-invasive predictor for subsequent jaundice. In patients with proven hemolysis, carboxyhemoglobin when compared to TcB was found to increase significantly in the first 3 hours of life more than TcB, stalting hour 4 till time of discharge it was increased yet statistically insignificant

Conclusion
We found that non-invasive carboxyhemoglobin is an effective early predictor for subsequent jaundice starting first hour of life. It can be used as a screening tool for hemolytic jaundice especially in hospitals with early discharge policy.
Anaphylaxis in Children: Experience of an Egyptian Center
Authors: Ezzat Mohamed Hesham Mohamed , Shousha Ghada Abdel Haleem , Gabal HebatAllah Mohammed Salah , Mousa Mousa Mohamed Hani 
Published: October 2021

Abstract

Introduction
Anaphylaxis is a potentially life threatening allergic reaction that is rapid in onset and multisystemic in nature. Distribution of anaphylaxis tends to fluctuate based on age, gender, race, geographical residence and socioeconomic status of the involved subjects. Diagnosis of anaphylaxis in children is generally underestimated particularly in developing countries, and when diagnosed, proper management is occasionally lacking.

Aim of the study
to evaluate the frequency and pattern of anaphylaxis and mistakes in diagnosis and treatment among a group of Egyptian children and adolescents.

Subjects and methods
This observational study was conducted over 12 months duration, from 1st of March 2019 to the end of February 2020, in Children’s hospital, Ain Shams University, Cairo, Egypt, on children presenting to emergency department (ED). Anaphylaxis frequency, clinical presentation, triggers, diagnosis, management and long term follow up were assessed.

Results
frequency rate of anaphylaxis among children and adolescents was 0.43% (80/18816) over a year. Sixty percent of patients were infants. Biphasic reactions were reported in 11.3% of patients. The commonest trigger was food (22.5%) followed by medications (8.8%). Appropriate diagnosis of anaphylaxis by junior pediatricians was reported in all patients, with epinephrine given in most occasions in proper dosage and method (78.7%). Education of children and their caregivers, providing written plan, ready-to-use epinephrine and follow up appointment were deficient.

In conclusion
Anaphylaxis in children was relatively high particularly in infants, with food being the most common trigger. Diagnosis and early management of anaphylaxis in our University hospital was satisfactory, however, long term management and follow up were defective.