bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrity of Brainstem Vestibular Connections in Patients with Essential Tremor
Authors: Ali Shalash Ali Soliman , Mansour Alia Hassan , Mahmoud Eman Mones , Ibrahim Weheiba Hoda Mahmoud , Zaki Elkordi Aya Abdelhamid 
Published: November 2024

Abstract

Background
Essential tremor (ET) is the most common adult movement disorder, affecting about 4.6% of those aged 65 years and older. Recent studies have also demonstrated an association between ET and hearing impairment. Although different neuroanatomical structures and pathways are emphasized as possible explanations for essential tremor (ET), there is still an ongoing debate. This study aimed to assess the role of brainstem auditor responses and reflex pathways with ABR & vestibular-evoked myogenic potentials (VEMP) in patients with ET.

Aim of the Work
1. To assess peripheral & central vestibulocochlear function in patients with ET in comparison to controls & To correlate the degree of vestibulocochlear and brainstem pathway dysfunction to disease characteristics and severity.

Patients and Methods
24 patients were included, selected from outpatient clinics at recruited from movement disorders clinic at Ain Shams University Hospitals and fulfilled the criteria of diagnosis of ET (ET criteria were set forth in the Consensus Statement of the Movement Disorder Society) (Bhatia et al. 2018) and 24 healthy controls who were age and sex matched, selected from workers at outpatient clinic, Fahn Tolosa tremor scale (FTM) was used for assessment of severity of tremors in patients, in addition ABR parameters were recorded for both groups for assessment of upper & lower vestibular pathways.

Results
Our study showed that there was non-significant difference as regards the age and gender between the two groups, on the other hand there was significant difference between the patients and controls regarding prolongation of wave III & V latencies than healthy controls, with statistically significant positive correlation between wave length and the severity of tremor (p = 0.015).

Conclusion
The findings in our study highlight the involvement of vestibular pathway by utilizing the vestibular studies which justify the increasingly noticed hearing impairment in ET patients population & help us to further understand the pathophysiology of ET.
Quality of Life of Spinal Muscular Atrophy Patients Treated with Intrathecal Nusinersen before and during Treatment
Authors: Fahmy Nagia Aly , Hamdy Nabila , Taher Hany , Soliman Radwa Mohamed , Mekawy Aya Mohamed Amin Mohamed 
Published: November 2024

Abstract

Background
Spinal Muscular Atrophy (SMA) is one of the most common congenital neurodegenerative diseases with prevelance of 1-2 per 100,000 persons and incidence of 1 per 10,000 live births for all SMA types combined. This year, fourteen Egyptian chromosome 5q-related SMA patients had the chance to receive the medication Nusinersen under governmental aid. That is a great opportunity as the most limiting factor of receiving any of the three FDA approved treatments for SMA is still the tremendous financial burden.

Objective
To compare the total quality of life of the first Egyptian patients receiving the therapy in Cairo and also observe the progression of the eight domains of the 36 short health survey questionnaire. This is to assess the subjective changes on individuals during the first six months from course of medication.

Methods
Prospective longitudinal Pilot study in which each patient’s quality of life is measured in a quantitative form before receiving Nusinersen intrathecal injections and compared to the results after two months and six months of receiving regular Nusinersen therapy according to the standard protocol of injection of the medication. Patients were recruited from Ain Shams University Hospitals within a period of 6 months and they received the intrathecal injections of Nusinersen therapy in Nasser Institute Hospital of Research.

Results
By using 36-short form health survey, there is a statistically significant increase in total quality of life (Qol) with continuous elevation between the first loading doses completed at two months and first maintenance dose at six months. In regards to our results, we assume that the treatment Nusinersen would be of benefit in increasing the quality of life of SMA patients.

Conclusion
Nusinersen showed rapid positive alteration in the quality of life of recipients improving not only the motor functions of patients but rather enhancing many other aspects of their lives such as energy levels, pain during daily activities, social functioning and role limitations. This leads to an overall improvement of their quality of life in a statistically significant manner only in a relatively short period of time.
Predictors of Disability and Disease Progression among a Sample of Multiple Sclerosis Patients: An Egyptian Study
Authors: Ali Hagar Saad , Ahmed Nasef Ayman Mohamed , El Nabil Lobna Mohamed , Fouad Mohamed Mahmoud , Sayed khater Shaimaa 
Published: November 2024

Abstract

Background
Diagnosing secondary progressive multiple sclerosis (SPMS) requires careful examination of the gradual decline that occurs following an initial relapsing-remitting multiple sclerosis (RRMS) course. Unfortunately, a lack of definitive criteria for determining when RRMS transitions to SPMS poses a challenge to accurately studying the differences between the two stages of the disease.

Objective
In this study, we aim to discover the potential predictors of disability and disease progression in Egyptian multiple sclerosis (MS) patients.

Methods
This retrospective hospital-based cohort study included 3123 patients diagnosed with multiple sclerosis (MS) - according to the revised McDonald criteria 2017- recruited from the registry of the MS unit at Ain Shams University over 2 years; and their demographic, clinical, and MRI data were collected.

Results
during the study period; 213 (6.82%) patients were found to be SPMS, and 17 of them dropped out during the study. Females represented 132 (67.35%), the mean age at the onset of the disease was 26.75 ± 8.4 (SD) years. While the mean duration of illness was 16.11 ± 7.49 (SD) years. The mean EDSS of the patients was 6.056 ± 1.36 and the mean number of relapses in the first 2 years was 2.95 ± 1.67 (SD) years. The number and types of MRI lesions both at baseline and last available one (T2, T1 black holes) in the different anatomical locations (FLAIR) (periventricular, juxtacortical, infratentorial, and spinal) were correlated with the clinical and demographic data of the patients as well as with the EDSS score. The presence of periventricular and spinal cord lesions and brain atrophy at baseline were significantly correlated to high EDSS scores (P &lt; 0.001, P = 0.038 and P = 0.002) respectively. Also, the number of T2 lesions more than 10 was significantly correlated to the progression of the EDSS scores (P = 0.007) after linear regression analysis.

Conclusion
This study showed that the predictors of disability and disease progression in Egyptian MS patients include male gender, higher age at the onset of disease, increased number of disease relapses in the first 2 years, the presence of spinal cord lesions, brain atrophy, and more than 10 T2 lesion at the baseline MRI.
Assessment of Anxiety, Depression and Fatigue as Prodromal Symptoms that May Precede Multiple Sclerosis First Demyelinating Event or Symptom Onset
Authors: Nasef Ayman Mohamed Ahmed , Awad Eman Mahmoud , Abousteit Alaa Mohamed Sayed , Ibrahim Shaimaa Sayed , Hussein Kareem Abd Elhamed 
Published: November 2024

Abstract

Background
Multiple sclerosis (MS) is a neuroinflammatory and neurodegenerative condition that led to chronic neurological disability in adults.it is characterized by multiple remissions and relapses that eventually lead to the neurological disability.

Aim of the Work
In this study we assessed the prodromal period through assessing only patients recently diagnosed with multiple sclerosis and was done through specific scales in order not to miss mild cases or vague complains.

Patients and Methods
This study is a cross sectional study, starting from November 2022 till April 2022 attending to ASU- neurology department – MS unit. Patients diagnosed with multiple sclerosis for the first time attending MS unit in neurology department.

Results
The demographic data had also no statistically significant relation to the prevalence of main symptoms of fatigue, depression and anxiety among the studied sample which was similar to the studies assessing the prodromal symptoms in MS patients yet with limited assessing of the demographic data to only age and gender. Prevalence of fatigue among the sample came higher than the overall prevalence of fatigue in the general population and higher than the overall prevalence of fatigue symptoms in the outpatient clinics which could mount fatigue symptoms to be further studied as possible marker of multiple sclerosis yet could also be linked to the much larger sample size used in those surveys and different methods of assessment. Prevalence of depressive symptoms came out to be higher than the overall prevalence of depression worldwide and the overall prevalence of depression in Egyptian population which could mount the mood symptoms to be further assessed as prodromal factors yet with the same risk of bias for the much larger sample size used in those surveys and the different assessment method. Prevalence of anxiety symptoms came out to be higher than the overall prevalence of anxiety worldwide and higher than its prevalence in Egyptian population which could also mount the subject to be presented as future factor for the prodromal period of multiple sclerosis yet with the same factors of bias as mentioned before of much larger sample size and different assessment methods.

Conclusion
In our study the assessed symptoms of fatigue, anxiety and depression have had higher prevalence in recently diagnosed MS patients before their diagnosis than the reported prevalence of these symptoms worldwide and in the Egyptian population. According to the results these symptoms could mount to be further studied on larger scale as prodromal risk factors trying to remove any possible risk of bias in association with assessment of other symptoms signs and investigations.
Efficacy of Ultrasound Guided Sphenopalatine Ganglion Block versus Greater Occipital Nerve Block in Management of Chronic Migraine
Authors: Abdulghani Mohamad Osama , Reda Ramez , Hussein Tamer , ElSadek Ahmed Mohammed , Mohamed Sherien , Abdelmohsen Taha Nourhan 
Published: November 2024

Abstract

Introduction
Migraine is a common primary headache disorder, announced as the second largest contributors of disability-adjusted life-years in the Global Burden of Disease Study. However, different treatment modalities have emerged for migraine including ultrasound guided sphenopalatine ganglion block and greater occipital nerve block, but there weren’t enough studies that compared their efficacy to each other, despite showing efficacy against medical treatment in different types of headaches.

Materials and Methods
This study was a two-arm randomized controlled trial, included 40 patients, 20 in each arm, randomized by simple randomization, all patients were assessed initially by headache diary, HIT-6 and MIDAS scales. The patients underwent nerve block ultrasound guided, then followed up after one month by headache diary and HIT- 6 scale and three months by MIDAS.

Result
This study showed significant improvement in the two arms, with significant difference between both groups as regards the improvement, with SPG block showing better improvement.

Conclusion
This study highlighted the efficacy of nerve blocks in treatment of chronic resistant migraine, with SPG block showing promising response. This study recommends extending the study to involve a larger scale of patients to approve the efficacy of nerve blocks in such cases.
Frequency of Silent Lacunar Cerebral Infarction in Patients with Type 2 Diabetes Mellitus
Authors: Ibrahim Mohamed Hamdy , Mahmoud Afify Hossam El-din , Zaky Omar Ahmed , Ali Eltawab Nourhan Fekry , Khaled Elewa Mohamed 
Published: November 2024

Abstract

Background
Diabetes mellitus type II causes different stroke subtypes, particularly lacunar stroke. Most cerebral lacunar infarctions do not cause a neurological deficit. So, they are called “clinically silent”.

Objectives
We aimed to study the frequency of silent lacunar cerebral infarctions in patients with Type II diabetes mellitus and to identify patients’ demographic, laboratory, and imaging characteristics.

Patients and Methods
This Cross-sectional study was conducted at the Internal Medicine Department of Ain Shams University Hospital, and included 92 patients diagnosed with type II diabetes mellitus according to the American diabetes association’s 2021 criteria. Participants underwent comprehensive physical and neurological examinations to detect the presence of any subtle neurological signs, as well as HbA1c and lipid profiles. Brain imaging, with the Philips Achieva 3 Tesla MRI scanner, was utilized to detect silent cerebral lacunar infarctions.

Results
Silent cerebral lacunar infarctions were detected in 92.4 % of patients (85/92 patients) predominately in the Corona radiata, Centrum semi-oval, and subcortical areas including the Basal ganglia, Pons, and Thalamus.

Conclusion
Asymptomatic patients with Type II diabetes mellitus could have vascular cerebral changes without neurological symptoms. Brain MRI scanning can be recommended as a routine investigation in neurologically asymptomatic type 2 diabetic patients who have a mean age of 56.8± 7.86 years old, and duration of illness above 10 years, especially males, regardless of HbA1c and lipid profile levels, to detect early vascular ischemic changes.
Clinical Characteristics of Egyptian Patients with Active Secondary Progressive Multiple Sclerosis
Authors: Salah Soha Ahmed , Zakaria Magd Fouad , Abd El-Aziz Azza Abd EL-Nasser , Fouad Mohamed Mahmoud , El-Hafeez Mohamed Ali Abd 
Published: November 2024

Abstract

Background
Many challenges exist in the precise definition of secondary progressive multiple sclerosis (SPMS). Early diagnosis of active SPMS is getting more important as pharmaceutical treatment options are developed.

Objectives
This study aimed to assess the clinical characteristics of patients with active SPMS enrolled in a new registry in Egypt and compare it with 6-month follow-up assessment.

Methods
It is a longitudinal, hospital-based study, conducted in the multiple sclerosis unit of Ain Shams University Hospital, forty-six patients were enrolled in this study who fulfilled the 2017 McDonald criteria for MS, as well as that of active secondary progressive multiple sclerosis (SPMS). All patients are subjected to a full personal history, primary clinical assessment was done using EDSS, Symbol Digit Modalities test (SDMT), and timed 25-Foot Walk Test (T25FWT) and were followed up and compared by a 6-month assessment.

Results
The mean age of the studied group was 43.543 ± 8.326 (SD). Females represented 69 %. The mean age of MS onset was 29.565 ± 8.010 (SD), mean age of SPMS onset was 40.109±7.892 (SD). EDSS mean value at baseline assessment was 5.8 and increased to 6 in the 6-month follow-up with a significant difference between the two assessments (p &lt; 0.001). SDMT mean value in baseline assessment was 24 and deteriorated to 21 in the 6-month follow-up. With p-value &lt;0.001. Regarding T25FWT baseline mean value was 16 seconds and increased to 18 seconds during the 6-month follow-up with a significant p-value of 0.013.

Conclusion
This study showed the importance of highlighting other aspects than motor to detect progression in patients with MS and the importance of entangling different techniques for better and more accurate assessment and earlier detection of progression.
Perceived Parenting Styles and Parental Bonding among a Sample of Adolescents Attending Adolescents’ Psychiatry Clinic at Ain Shams University Hospital
Authors: Sayed Maha Muhammad , ElGhamry Reem Hassan , Hashem Reem Elsayed Mohamed , Mohamed Maryam Yahia , Awwad Yasmine Muhammad 
Published: November 2024

Abstract

Background
Although family history of mental disorders is one of the most consistent and potent risk factors for mental disorders in offspring, both familial and non-familial environmental factors are thought to play a role in etiology. Many aspects of parenting, ranging from daily interactions to potentially traumatic experiences such as abuse and inter-parental conflict, may be not only mechanisms through which parental disorders confer increased risk to offspring but also independent risk factors for mental disorders.

Aim of the Work
Our study aimed to study perceived parenting styles among adolescents with different psychiatric disorders compared to adolescents without psychiatric disorder, study both maternal and paternal bonding among adolescents with different psychiatric disorders compared to adolescents without psychiatric disorder.

Patients and Methods
Our study was conducted in Ain Shams university hospital, precisely in the outpatient clinic of Okasha institute of psychiatry. We compared 50 adolescents diagnosed with different psychiatric disorders to 50 healthy adolescents. Participants were recruited from the outpatient clinic while a matched group of adolescents without psychiatric disorders was recruited from adolescents of employee working in Okasha institute of psychiatry.

Results
adolescents with different psychiatric disorders perceived their parents as more authoritarian, less authoritative. they also perceived their mothers as less permissive, while there was no significant difference between both groups regarding father's permissiveness. Low level of care and high level of overprotection were significantly correlated with all psychiatric disorders in the study group.

Conclusion
Pathogenic parenting styles characterized by high level of control and overprotection and low level of care are associated with wide range of psychiatric disorders in adolescents, while parenting styles characterized by high level of care seem to be protective against psychiatric disorders in adolescents.
A Comparative Study of Post-Operative Outcomes with and without Using Intraoperative Neurophysiological Monitoring in Intra Medullary Spinal Cord Tumors Surgeries; A Systematic Review
Authors: Mustafa Hazem Ahmed , Hamada Salah Mustafa , Ashour Ahmed Maamoun , Emam Abdelrahman 
Published: November 2024

Abstract

Background
Although relatively infrequent, neurological injury is a much dreaded complication in spine surgery and has the potential to result in serious postoperative motor and sensory deficits. As a result of these surgical challenges, intraoperative neuromonitoring (IONM) has gained favorable grounds in facilitating maximal tumor resection and minimizing neurologic morbidity.

Aim and Objectives
to review the efficacy of intraoperative neurophysiological monitoring (IONM) on post operative outcomes preventing neurological injury, predicting post operative neurological deficit and its effect on intraoperative surgeon’s decision making, and to know if it is beneficial or not in intramedullary spinal cord tumors surgeries in adults.

Subjects and Methods
This was observational studies and non randomized controlled studies. our patients were followed up according to this schedule (immediate post operative, first day, three days, first month, three months, six months, one year post operative) and the assessment were done by using Oxford grading system.

Result
Regarding neurological status by clinical examination at last follow up, Improved in 72, transient worsening in no cases, no change in 12 cases and progression in 17 cases, Conclusion.

Conclusion
our systematic review of the literature indicates that there is strong evidence that multimodality neuromonitoring is sensitive and specific for detecting intraoperative neurologic injury during spine surgery. Although the level of evidence supporting the conclusion that intraoperative neuromonitoring reduces the rate of new or worsening neurologic deficits is low, the available evidence does consistently support this conclusion.
Management of Chronic Sacroiliac Joint Pain; Conservative versus Minimally Invasive Intervention versus Sacroiliac Joint Fusion; A Systematic Review
Authors: Mohamed Ismail Mohamed Awad , Ali Nosseir Mohamed ElSayed , Abouelela Abdelmawla Radwan Hesham Mohamed , Abdelrahman Mohamed Abdelrahman Mahmoud 
Published: November 2024

Abstract

Background
Chronic sacroiliac joint (SIJ) pain poses a significant clinical challenge, and the choice between conservative management and minimally invasive interventions or SIJ fusion is an ongoing debate. This systematic review and meta- analysis aimed to compare the effectiveness and safety of SIJ fusion versus conservative treatment versus minimally invasive interventions in patients with SIJ pain of degenerative origin or following lumbar fusion.

Methods
A comprehensive search of PubMed, Web of Science, and Scopus databases was conducted using a predefined search strategy. The search process adhered to the PRISMA guidelines and utilized Cochrane's systematic review methods. Eligible studies were identified through a two-step screening process, and data were extracted for analysis, including visual analog scale (VAS) scores, Oswestry Disability Index (ODI), Short Form-36 (SF-36) scores, and recurrence rates of low back pain. Risk of bias was assessed using Cochrane's risk of bias tool for randomized clinical trials and the ROBINS-1 tool for non-randomized clinical trials.

Results
Sixteen studies met the inclusion criteria, and a detailed analysis of subgroups and overall outcomes was conducted. The results showed that VAS scores at baseline favored the conservative treatment, while VAS score improvements at 3 months were more prominent in the fusion procedure. At 9 months or more, both minimal intervention and fusion procedures demonstrated significant improvements. Regarding ODI, fusion procedures were associated with higher baseline scores, but significant improvements were observed at various time points. In contrast, the conservative treatment showed significant ODI improvements at 3 months. The SF-36 scores varied, with minimal intervention appearing more favorable for SF-36 PCS and MCS after 12 months.

Conclusion
The choice between SIJ fusion and conservative treatment should be tailored to the specific outcome of interest. Fusion procedures, especially for VAS scores and ODI at various time points, offer benefits, while conservative treatment is effective for early ODI improvements. For long-term functional and pain outcomes, both minimal intervention and fusion procedures demonstrate efficacy, with a slight advantage for the fusion procedure. Ultimately, treatment decisions should consider individual patient needs and desired outcomes. Further research is needed to refine treatment recommendations and enhance patient outcomes.