bluuebunny/crossref_metadata_2025_split huggingface dataset:
Induction chemotherapy with capecitabine and oxaliplatin followed by chemoradiotherapy before surgery in patients with locally advanced rectal cancer (A phase II study)
Authors: Elhawi Mai Ezzat , Azmy Aly Mohammed , Ghali Ramy Refaat Youssef , Gobran Ass. Prof. Dr. Nagy Samy , Shakweer Ass. Prof. Dr. Marwa Mosaad , Mohammed Doaa Atef 
Published: October 2021

Abstract

Background
Locally advanced rectal cancer (LARC) has a high incidence of local and distant relapse even after adequate treatment. The emerging role of neoadjuvant induction chemotherapy may allow initial down staging of the primary tumor, less toxicity profile and early treatment of micrometastatic disease followed by chemoradiation, and optimum local control may be attained, with the hope of increased complete response rates

Objectives
to identify the effect of induction chemotherapy with oxaliplatin and capecitabine (CapeOx) before concurrent chemoradiation in locally advanced rectal cancer in terms of response and toxicity. Primary end point is assessment of complete pathological response rate.

Patient and Methods
patients with MRI based criteria of high-risk LARC (T4 tumors, tumors within 2 mm of mesorectal fascia, T3 tumors at or below levators and T2-4N+ve tumors) were included. Patients received 12 weeks of induction capecitabine/oxaliplatin followed by concomitant capecitabine and conventional three dimensional conformal radiotherapy. Surgery was done at least 6 weeks after CCRTH.

Results
Thirty five patients with LARC were recruited during the period from December 2017 till January 2019. Five patients (20.8%) had a pathological complete response (TRG 0) (ypT0N0). Another three patients (12.5%) had near complete pathological response (TRG 1). While unfortunately 29.2% and 37.5% had partial response and poor response respectively.

Conclusion
Induction chemotherapy could be a promising option for better response rates either clinical or pathological for high risk LARC patients with acceptable toxicity profile.
Evaluation of the Effect of Combination Chemotherapy with Five-day Infusion of Fluorouracil Plus Vinorelbine in Pretreated Metastatic Breast Cancer Patients
Authors: Kamel Tarek , Din Mai Ezz El , Nagy Ahmed , Salah Rasha 
Published: October 2021

Abstract

Background
continuous infusion (CI) of 5-fluorouracil (5-FU) has proven in several studies to be an active and well tolerated treatment for advanced pretreated breast cancer. Navelbine has also shown activity in this setting.

Aim
This is retrospective study to evaluate the clinical activity and side effects of a combination chemotherapy consisting of a five-day continuous infusion of fluorouracil and i.v. vinorelbine in metastatic previously treated breast cancer patients.

Patients and Methods
Fifty-four patients received 5FU 600 mg/m2/d for 5 consecutive days as a continuous infusion and vinorelbine 25 mg/m2 on days 1 and 5 as a short intravenous (I/V) infusion every 3 weeks.

Results
Eleven (20.4%) complete responses, 20 (37%) partial responses and 14 (25.9%) stationary disease were documented, accounting for a clinical benefit rate of 83.3%. The median progression free survival was 6.8 months. The median overall survival was 25.8 months. Treatment was well tolerated, with Grade 3 anemia, febrile neutrobenia and stomatitis in 9.3%, 5.6% and 1.9% respectively as the main toxic reactions. Conclusions: This drug combination is active in metastatic previously treated breast cancer patients with acceptable toxicity profile.
Anterior Approach of Total Hip Arthroplasty, a Systematic Review
Authors: El-Helaly Haitham Abdel-Azem , Zakaria Zeiad M , Mohsen Ahmed Essmat Abdel 
Published: October 2021

Abstract

Background
There are 3 commonly used surgical approaches to the hip: the anterior, lateral [anterolateral (Hardinge) and direct lateral (Watson-Jones)].and posterior approaches. Each one is different from the other in anatomy, technical aspects, outcome and complications. However there is no current consensus regarding which approach is the most suitable.

Aim of the Work
To compare various clinical outcomes and complication rates across the 3 approaches focusing on direct anterior approach which may influence surgeon choice in the future and to identify which approach is the best for THA.

Patients and Methods
This systematic review and network meta-analysis were conducted following guidelines in the preferred reporting items for systematic reviews and meta-analyses (PRISMA), extension of network meta-analyses. The outcomes of interest were VAS, HHS and postoperative total complications after THA. Methods of measure for these outcomes were used according to the original studies.

Results
The lowest VAS pain and highest HHS after THA is the anterior approach followed by the lateral approach. The best approach class that had the lowest complications was posterior followed by the lateral approach, and the anterior approach had the highest risk of having complications after THA. Although the anterior approach had efficient postoperative outcomes, it should still be use with caution due to the high complication rates.

Conclusion
The best surgical approach for the lowest VAS pain and highest HHS after THA is the anterior approach followed by the lateral approach. The best approach class that had the lowest complications was posterior followed by the lateral approach, and the anterior approach had the highest risk of having complications after THA. Therefore, the use of the posterior approach is safe for THA, whereas although the anterior approach had efficient postoperative outcomes, it should still be use with caution due to the high complication rates.
Study the Results of Antibiotic Prophylactic Protocol Adopted by Ain Shams University Hospitals for reducing the Risk of Surgical Site Infection in Patients undergoing Hip Arthroplasty, Pilot Study
Authors: Zaher El Zaher Hassan El , Samir Shady , Khaled Ahmed Mohamed , Farrage Ahmed Mohamed Abdel Rahman Mohamed 
Published: October 2021

Abstract

Background
Total hip arthroplasties are well-proven solutions in case of end-stage osteoarthritis of the hip joint. Although, presence of complications can be devastating for the patient, especially periprosthetic joint infection (PJI). To prevent PJI, antibiotic prophylaxis regimens are regularly used.

Objectives
To study the association of antibiotic choice, duration and dosage with prevalence of surgical site infection among patients with hip arthroplasty and identify risk factors for surgical site infection in patient with hip arthroplasty.

Patients and Methods
After obtaining the hospitals Research/Ethics Committee approval and written informed consents from the patients, this study was carried on. 30 patients with primary hip arthroplasty surgery and all operations were performed by senior staff members. All patients were screened for suitability by detailed clinical assessment of their history and physical examination as well as radiological investigations.

Results
The result of this study was that we have 2 cases infected from 30 cases with percent of infection among patient with primary hip arthroplasty is 6.7% and by studying the risk factors for infection there was no specific risk factor for infection except for patient with cardiac disease have increased risk of infection.

Conclusion
In conclusion, this study postulated that systemic antibiotic prophylaxis delivered preoperatively in primary THA procedures significantly reduces the incidence of infection. There is no significant difference in the efficacy of cephalosporins compared with that of quinolones. Prophylactic antibiotics should be taken IV before skin incision by 30-60 minutes and no need for antibiotics more than 24 hours after operation.
Minimally Invasive versus Open Repair for the Treatment of Acute Achilles Tendon Rupture in Adults: A Prospective Randomized Controlled Study
Authors: Ghaly Nabil Abdel Moneam , Elbeltagy Atef Mohamed Fathy , Rahman Amr Farouk Abdel , Hamed Mahmoud Ahmed 
Published: October 2021

Abstract

BACKGROUND
The aim of this study is to compare open repair and minimally invasive repair in acute Achilles tendon rupture in adults regarding operative techniques, functional outcome and complications.

DESIGN
A prospective randomized controlled comparative trial.

METHODS
40 consecutive cases with acute complete Achilles tendon rupture were divided randomly in 2 equal groups (20 treated by open Krackow repair and 20 treated by minimally invasive repair with the PARS device), average age 41 years, follow up time was average of 7 months. Patients were assessed clinically and functional scoring system of postoperative American Orthopaedic Foot & Ankle Society ankle-hindfoot score (AOFAS) was used postoperatively.

RESULTS
Our results found that there were no significant differences between both groups in rates of postoperative complications (MIS group 10%, open repair group 15; P = 0.134). PARS group had greater postoperative AOFAS score, early rehabilitation, better cosmetic appearance and smaller scar length than open Krackow repair of acute Achilles tendon rupture.

CONCLUSIONS
We have found out that minimally invasive techniques such as the PARS are clinically and biomechanically suitable alternatives to open repair based on both clinical outcomes and repair strength.
Hip arthroplasty for failed internal fixation of intertrochanteric fractures: A Systematic Review and Meta-Analysis
Authors: Makram Milad Khair , Eid Ahmed Salem , Sallam Ahmed Mohamed 
Published: October 2021

Abstract

Background
hip replacement is a satisfactory salvage procedure for failed fracture treatment despite the increased operative difficulty.

Objectives
the purpose of this systematic review and meta-analysis was to review and study literature regarding conversion arthroplasty in patients with failed internal fixation of intertrochanteric fractures to evaluate the results, technical problems and complications, as well as the impact of different variable factors and age. associated with hip arthroplasty and to evaluate the functional outcomes and complications..

Materials and Methods
A systematic review of 3 databases (PubMed, Cochrane, and Embase) was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria were English-language studies that reported complications or functional outcomes after failed fixation of IT fractures with hip arthroplasty in adult subjects (&gt;18 years of age).

Results
About 2041 articles were found using search keywords as shown in PRISMA flow chart, By filtration and screening of the title and exclusion of unrelated articles, about 109 articles were found, By applications of all inclusion and exclusion criteria, only 8 articles were fit to undergo this meta-analysis.

Conclusion
So this study showed a significant improvement in functional outcome of hip arthroplasty after failed intertrochanteric fixations despite the relative complication rate of this procedure.
Role of ultrasound guided injection of platelet rich plasma (PRP) in knee osteoarthritis patients
Authors: Mohamed Ahmed Emad Mahdy , Hassan Mohamed Sobhy , AbdelMotelib Mohamed Gamal Eldin 
Published: October 2021

Abstract

Background
Multiple promising researches were done regarding using platelet rich plasma (PRP) injection aiming at establishing new minimally invasive treatment option for knee OA and avoiding surgical procedures hazards which could be an option in advanced cases. Thus, our study will be directed towards ultrasound guided injecting of PRP trying to confirm the efficacy of the procedure as a therapeutic option.

Objective
The study aims to assess of the role of ultrasound guided PRP injection in cases of knee osteoarthritis and follow up of the symptoms outcome.

Methods and material
Twenty patients with different knee osteoarthritis grades were injected with PRP under ultrasound guidance and the symptoms outcome were followed up by using visual analogue scale (VAS), WOMAC osteoarthritis index, OXFORD knee score, LYSHOLM knee scoring scale at periods of , and weeks post procedure.

Results
A total of patients were included with the age ranging from - years old, the mean was . years old (SD ± . ). Among them patients ( ) were females and patients ( ) were males. There was statistically significant difference between the different knee pain scoring scales , and weeks after the procedure compared to before injection, where according to VAS score the mean score was . . pre procedure and became . . , . . and . . after , and weeks respectively with mean reduction ratio of . % after months. The extent of the difference over the periods through WOMAC in knee osteoarthritis patients was . . ,. . and . . after , and weeks respectively, compared to . . before the procedure with a mean reduction ratio of . % after months. While according to OXFORD knee score, the patient’s scores were . . before the procedure Vs . . , . . and . . at , and weeks after injection with symptoms mean reduction ratio of . %. According to LYSHOLM knee scoring scale, the mean score was . . pre procedure and became . . , . . and . . after , and weeks respectively with months mean reduction ratio of . %.

Conclusion
PRP injection in symptomatic knee osteoarthritis patients cause statistically significant improvement of the symptoms.
Corpus Callosum Microstructural Alterations In Children With Memory Related Learning Disability: A Diffusion Tensor Imaging Study
Authors: Abd elhameed Abeer Maghawry , Mohammad Shaimaa Abdelsattar , Nashaat Neveen Hassan , Abdel-Rahman Amgad Samy , Raouf Ehab Ragaa Abdol 
Published: October 2021

Abstract

Purpose
The purpose of this study is to assess the corpus callosum microstructural changes in children with memory related learning disability.

Methods
DTI was performed in 20 patients with memory related learning disabilities (MRLD +) and 22 matched healthy control subjects (MRLD -) aged 7– 13 years. Fractional anisotropy (FA), axial diffusivity, radial diffusivity (RD) and trace were calculated for corpus callosum. Comparison between patients with memory related learning disabilities (MRLD +) and healthy control subjects (MRLD -) was performed. DTI metrics were correlated to clinical digit span backward scores in (MRLD +) group. A pvalue less than .05 was considered significant.

Results
The corpus callosum showed a highly significant higher FA and lower diffusivity indices in (MRLD +) group compared to the (MRLD -) group (p &lt; 0.001). No significant correlation between the clinical test “digit span backward” scores and DTI metrics of the corpus callosum was found.

Conclusion
Changes in DTI metrics of corpus callosum in patients with memory related learning disabilities reflects white matter micro-structural changes. Higher FA values and lower diffusivity indices do not necessarily indicate healthier white matter but, can indicate pathology.
CT of pelviabdominal masses in pediatrics: Diagnostic algorithm
Authors: Awwad Amina Osama Mohamed , Ahmed Hanan Eissa , Mohammed Shaimaa Abdelsattar 
Published: October 2021

Abstract

Background
Pelviabdominal masses are common in children. It can be a leadig cause of considerable morbidity and mortality.

Objective
To review the different pelviabdominal masses and their diagnostic criteria using the multidetector CT scans in order to build an approach for diagnosis.

Methods
A retrospective study, conducted at Ain Shams University hospitals on children complaining of pelviabdominal masses, the patients were investigated using CT scans in the period between June 2018 till end of May 2019.

Results
pelviabdominal CT scan of 70 patients were reviewed. Their age ranged from 7 days to 18 years old, the mean was 8 years of age (SD ± 5.5). 31 male : 39 female. Abdominal masses of pediatrics were congenital ( 9 case), neoplastic ( 20 cases), inflammatory ( 23 casaes) and post traumatic in origin (3 cases).
The most common congenital masses were PUJO, neoplastic were neuroblastomas, inflammatory were abscess.
Diagnostic approach should start with determination of the organ of origin followed by determination of its morphology and pattern of contrast enhancement.
The kidney was found to be the most common organ of origin in 25.7% of cases followed by the adenxa.

Conclusion
the organ of origin and morphology of the lesion are key imaging features that will help the radiologist reach a definitive diagnosis or deliver a possible differential diagnosis.
Improving the accuracy of contrast enema in diagnosis of Hirschsprung disease
Authors: Eskander Amir M , Mansour Hesham M , Ali Shehata Khaled A 
Published: October 2021

Abstract

Background
Hirschsprung’s disease (HD) is one of the most important causes of chronic constipation in children due to its possibly fatal Amir Maurice Eskander complications if left untreated. Contrast enema (CE) is the first investigation done to diagnose Hirschsprung’s disease as it’s the safest, least invasive, most widely available and least expensive as compared to anal manometry and rectal biopsy however it had shown a wide range of sensitivity and specificity in previous studies.

Aim of the work
to improve the accuracy of contrast enema by studying each possible abnormal finding related to Hirschsprung’s disease and calculating its sensitivity and specificity in comparison with biopsy, as a gold standard method to determine the most reliable signs to use for diagnosis.

Patients and Methods
This cross sectional study was carried at pediatric radiology unit Ain Shams university hospitals, starting from July 2018 to June 2019. 43 patients met all inclusion and exclusion criteria and were included in the study. Contrast enemas results and findings were compared to the patient’s final diagnosis. PPV, NPV, specificity, and sensitivity was calculated for each finding.

Results
Absence of rectal gas in the plain film, transitional zone, abnormal recto-sigmoid index, enlarged colonic caliber and delayed evacuation showed significant association with HD. Abnormal recto-sigmoid index was the most reliable sign in our study to diagnose HD having the highest sensitivity and specificity.

Conclusion
CE is an excellent initial investigation in HD and combining it with detailed history taking and clinical examination can lead to decrease in unnecessary rectal biopsies.
Thyroid Imaging Reporting And Data System (TIRADS) For Ultrasound Features Of Solitary Thyroid Nodules
Authors: Salah Amr Salama A , Abu-Gamrah Sherif H , Hussein Ahmed M , Nasser Haytham M 
Published: October 2021

Abstract

Purpose
to investigate the Thyroid Imaging Reporting and Data System (TIRADS) as a new classification system for solitary thyroid nodules by high resolution Ultrasonography in correlation with histopathological study.

Materials and Methods
Thirty patients with clinically suspected thyroid nodules referred to Radiology department at Ain shams University hospitals after fulfilling inclusion and exclusion criteria. All thyroid nodules are examined by ultrasound and charactrized according to internal components, margins, echogenicity, shape and evidence of echogenic foci the classified according to the American college of radiology (ACR) TIRADS guidline, then compared with histopathological examination by Fine needle aspiration cytology (FNAC) .

Results
Many ultrasound features were predeictors of malignancy hypoechoic echopattern, taller than wider shape, punctate echogenic foci, and lobulated and irregular margins with (p &lt; 0.05). Risk of malignancy on TIRADS 1 and 2 nodules were 0%, also on TIRADS 3 nodules was 0%. While on TIRADS 4 and 5 nodules were 11.1% and 88.9% respectively. ROC analysis revealed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under curve (AUC) are 100, 85.71, 75.00, 100.00 and 0.987 respectively when using cut-off value of score &lt;5.

Conclusion
Our results suggest that ACR TIRADS classification is reliable in predicting thyroid malignancy. It could lead to a significant decrease of the number of unnecessary FNAC.
Comparison between manual and automated CT liver volumetry in assessment of the liver volume in living donor liver transplantation
Authors: Kamal Omina Ahmed , Azab Enas Ahmed , Mahmoud Ahmed Abdelsamie , Abdeldayem Emad Hamid , Taha Eslam Mahmoud 
Published: October 2021

Abstract

Aim of the work
To evaluate the effectiveness and advantages of automated CT volumetry in the assessment of liver volume in living donor liver transplantation and to compare this technique and its results with those calculated from manual volumetry.

Materials and Methods
This comparative study was conducted on dynamic contrast enhanced hepatic CT scans of 21 potential living liver donors. All potential donors underwent 1st step laboratory investigations to enter the 2nd step investigations for living donor liver transplantation operation. Automated liver volumetry was developed using the Myrian® XP-Liver software. To establish reference standard liver volumes, a radiologist manually traced the contour of the liver on each CT slice. We compared the results obtained with automated with those obtained with the reference standard for this study, manual volumetry.

Results
The study showed that automated CT liver volumetry achieved excellent agreement with manual volumetry without statistical significance. The average processing times for automated volumetry was 3.09 ± 0.44 min/case, whereas those for manual volumetry were 16.23 ± 0.81 min/case, the difference was statistically significant (p &lt; 0.05).

Conclusion
Automated CT liver volumetry performed using the Myrian® XP-Liver software can accurately predict the preoperative liver volume and provide acceptable measurements comparable to the gold standard manual volumetry.
Cost-Benefit relationship between Hand Held Ultra-Sound (HHUS) and Automated Breast Ultra-Sound (ABUS) as a complementary scan for Mammography in detection of breast lesions
Authors: Abu El Maati Amal A , Ragheb Samar R , Moustafa Esraa E 
Published: October 2021

Abstract

Aim of the Work
to compare between HHUS and 3D ABUS, according to their benefits and limitations as a complementary scan for mammography in detection of breast lesions.

Patients and Methods
The study was conducted on 30 female patients with breast masses diagnosed by clinical examination or by sonomammography in Radiology Department at Al Sheikh Zayed Aal Nahian hospital and Ain Shams University Hospitals during the period from October 2018 and August 2019. Findings were confirmed by histopathological biopsy or at least 6 months follow up.

Results
Statistically significant difference between ABUS and HHUS time of examination in favor of ABUS with P-value &gt;0.0001 and 95%CI-5.7:-4.4, as ABUS time of examination was (mean+/- SD: 4.1 +/-0.9) and HHUS was (mean +/- SD: 9.2 +/-2.0). In this study; 8 out of 30 were malignant lesions and 22 were benign findings. HHUS showed higher sensitivity than ABUS (100% versus 88%); specificity (86%, 91%), positive predictive value (73%, 78%) and negative predictive value (100%, 95%) respectively. HHUS and ABUS shows nearly perfect agreement regarding lesion classification(benign &malignant).with Cohen’s kappa (κ) 0.85, and also regarding BIRADS classification With Weighted kappa 0.824.

Conclusion
There is a near perfect agreement between ABUS and HHUS diagnostic performance (κ) 0.85,and statistically significant difference in time of examination in favor of ABUS as it is operator independent and provide large scanned area in every single sweep and also aided with computer software, but HHUS still have higher sensitivity than ABUS and that may be attributed to ABUS limitations to evaluate axillary lymph nodes and lack of Doppler, so ABUS may serve as an effective, adjunct, screening tool to mammography and hand held Sonography.