bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study between Dynamic Hip Screw (DHS) with Lateral Stabilizing Plate versus Proximal Femoral Nail (PFN) in Fixation of Unstable Intertrochanteric Fractures. A Systematic Review & Meta-Analysis
Authors: Abdelfattah Ali Khorshid Mohamed Ahmed , Abdelmegid Wael Samir , Zakaria Zeiad Mohamed 
Published: November 2024

Abstract

Background
Intertrochanteric fractures are one of the elementary orthopaedic clinical problems accounting for 7% of osteoporotic fracture. These kind of fractures usually caused by low-energy trauma such as a fall from standing height with several risk factors including; increasing age, female gender, osteoporosis, a history of falls, and gait abnormalities. Usually intertrochanteric fracture is classified according to its stability. Fracture stability is dependent on the status of the posteromedial cortex. Stable fractures are commonly simple fractures which are less affected by vertical stress during one-leg standing. Unstable intertrochanteric fracture has decreased ability to resist stress due to affection of Posteromedial or Lateral femoral cortex.

Patients and Methods
Asystematic review & Meta analysis was design with a careful consideration of the Cochrane Handbook for Systematic Reviews of Interventions. We also will follow The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines during the design of our study. Population: Patients with unstable Intertrochanteric fractures, intervention: Dynamic hip screws (DHS) with lateral stabilizing plate(TSP), comparator: Proximal Femur Nail, outcome parameters: Functional and radiological, study design: Clinical trials whether randomized or nonrandomized prospective or retrospective cohort, case control studies.

Results
Use of TSP with DHS can give good results in unstable inter trochanteric fractures. As compared to DHS with TSP, PFN is technically more demanding surgery and in our meta analysis and systematic review study we found complication rate of PFN to be higher as compared to DHS with TSP. Addition of TSP to DHS gives good lateral wall buttress which prevent excessive medialization of shaft and gives comparable result to PFN which is considered as better implant in unstable fractures.

Conclusion
The current systematic review indicated that there is no statistically significant difference between patients operated with Dynamic Hip Screw with Trochanteric lateral Stabilization Plate and Proximal Femoral Nail.
Management of Comminuted Tibial in Adults Plateaue Fractures by Ligamentotaxis with Minimal Internal Fixation
Authors: Abou Seif Salah Abdel gawad , Thakeb Mootaz Fouad , Khaled Mohamed Al Sharkawy Shady Samir Fekry Mohamed 
Published: November 2024

Abstract

Purpose
To evaluate the clinical and radiological outcome of complex tibial plateau fractures treated with external fixation with or without minimal internal fixation.

Methods
This prospective review was conducted on all the cases of Schatzker types V and VI tibial plateau fractures treated by Ilizarov or LRS external fixation between September 2021 to February 2023 with the minimum follow-up duration of 18 months. There were 15 patients: 10 males and 5 females, mean age 36.7 years, four of them were open fractures; 13 cases were Schatzker type V fractures and two cases were type VI. Outcome assessment was made with American Knee Society Score (AKSS) and Rasmussen's Radiological Score (RRS) at final followup.

Results
Out of the 15 cases, mini-open reduction was performed in 6 cases, minimal internal fixation in 8 cases. Mean duration of external fixation was 10.2 weeks. All fractures united except one case. Pin tract infections in 7 and common peroneal neuropathy was detected in one patient and was self limiting. Two patients had axial malalignment of less than 10°. At final follow-up, the mean knee range of motion was 114.7, mean AKSS is 75.2 and mean RRS is 12.8. On statistical analysis; Schatzker type of fractures, use of minimal internal fixation and knee spanning did not influence the final outcome.

Conclusion
Ilizarov external fixator with or without minimal internal fixation provides acceptable outcome for complex tibial plateau fractures. Care must be taken to look for minor loss of alignment, especially in Type VI Schatzker fractures after removal of the fixator. However small sample size precludes firm conclusions.
Dynamic Locked Plating Using Near-Cortical Over-Drilling versus Standard Locked Plating for Fixation of Lower Femur Fractures
Authors: Thakeb Mootaz Fouad , Mohamed Fayyad Tamer Abd El Maguid , El Gebeily Mohamed Abd El Moneim , Wahba Mohamed Kotb Mohamed , Al Kersh Mohamed Ahmed 
Published: November 2024

Abstract

Background
Fracture Healing in distal femoral fractures is greatly influenced by fixation method. Classic compression plate requires creation of a rigid plate/bone construct which involves soft-tissue stripping and devitalization of the underlying bone, this may lead to inhibited callus formation. Hence, the concept of “Dynamic” Locked Plates has been proposed to decrease construct stiffness and improve callus formation.

Aim of the Work
To compare functional and radiological outcomes in lower femur fractures treated by dynamic locked plating (using near cortical over drilling) to that treated by standard locked plating.

Patients and Methods
Prospective study was conducted starting from May 2020 to January 2023 including 30 patients aged from 18 to 65 years old with distal femur fracture treated by dynamic locked plating with near cortex over drilling (15 patients) or standard locked plating (15 patients). We excluded patients with open fractures, periprosthetic fractures, floating knee injuries and poly-traumatized patients. The follow up period was 1 year.

Results
The current study demonstrated no statistically significant difference between both groups regarding time of union, knee range of motion, nonunion rate, or other specific complications. However, the DLP group was noted to have statistically significant higher callus scores at six weeks postoperative (p value = 0.015) indicating increased callus formation.

Conclusion
Dynamic locked plating seems to result in improved callus formation and bone healing without sacrificing fixation strength compared with traditional locked plating when used for fractures of the distal femur.
Evaluation of SOX10 Immunohistochemical Expression in Mammary Carcinoma
Authors: El-Maraghy Maissa N , Farid Rola M , Elgohary Shimaa A E , Fawzy Bakinam M 
Published: November 2024

Abstract

Background
Invasive breast cancer (IBC) is the most frequent malignant neoplasm of female patients accounting for around 25% of all recorded cases globally. IBC is classified into five molecular subtypes. Triple-negative breast carcinoma (TNBC) are IBCs that lack expression of all three routine biomarkers; namely ER, PR, and Her2neu, it forms about 15-25 % of all IBCs. TNBC is characterized by its high degree of aggressiveness and greater recurrence and metastasis rates. Metastatic TNBC might be challenging to distinguish from other metastatic adenocarcinoma that are ER, PR, and Her2neu negative. Other sensitive & specific immunohistochemical markers are required to help distinguish primary from metastatic carcinomas, especially TNBC. Recently Sox10 has been suggested to be regularly expressed in primary breast cancers, particularly basal-like breast cancers and metaplastic TNBC.

Objective
This is primarily to evaluate the immunohistochemical expression of SOX-10 in invasive breast cancer in general and its expression in triple-negative breast cancers (TNBC) compared to other molecular subtypes.

Methods
This retrospective study included 62 TNBC cases and 21 non-TNBC cases. The immunohistochemical expression of Sox10 was tested, evaluated, and compared in different study groups with subsequent statistical analysis.

Results
Sox10 expression was positive in 39 cases of TNBC (92.9%) compared to only 3 cases of non-TNBC (7.1%). The SOX10 expression was significantly expressed in TNBC (p &gt; 0.001). This expression was more frequent in TNBC compared to non-TNBC (p-value &lt; 0.001). Moreover, Sox10 was more frequently expressed in TNBC than other molecular subtypes of primary breast cancer (p- value = 0.001).

Conclusions
Sox10 is more highly expressed in TNBC than other molecular subtypes of non-TNBC. It may represent a potentially valuable diagnostic marker for other hormone receptor-negative tumors in the metastatic setting.
Evaluation of GARP Immunohistochemical Expression in Papillary Thyroid Carcinoma
Authors: Atia Esraa Adel Mahmoud , Sammour Sanaa Abd Elmaged , Ibrahim Eman Abdel-Salam , Gabal Hoda Hassan Abou , Elgohary Shimaa Abdelraouf 
Published: November 2024

Abstract

Background
Glycoprotein A repetitions predominant (GARP) is a novel trans-membrane protein, highly expressed on the surface of regulatory T cells (Tregs). Tregs are a subset of immunosuppressive T-lymphocytes that play a major role in inhibiting antitumor immune response. Many studies documented increased GARP expression in various tumors. Our study was designated to evaluate the immunohistochemical (IHC) expression of GARP in differentiated thyroid carcinomas and their tumor infiltrating lymphocytes (TILs) in comparison to its expression in other benign and low-risk lesions and to assess the potential diagnostic role of GARP IHC expression in different thyroid lesions.

Material and Methods
Sixty-nine cases of different thyroid lesions subgrouped into: 37 cases of malignant thyroid neoplasms, 25 cases of benign thyroid lesions and 7 cases of low-risk neoplasms collected from pathology department laboratories of Ain Shams university hospitals during the period from January 2017 to December 2021 and stained immunohistochemically for GARP. IHC expression of GARP was evaluated in thyroid epithelial cells and TILs. The expression of GARP was correlated with the different clinicopathological parameters.

Results
GARP expression discloses significant statistical difference between the three studied groups (p &lt; 0.001). High GARP expression was detected in 89.19% of the malignant cases and in 28.57% of low-risk neoplasms, while all benign lesions exhibited low GARP expression. No statistically significant correlation was detected between GARP expression and patient’s age or sex, as well as tumor focality, extrathyroid extension, and cervical lymph node metastasis (MTs). High GARP expression of TILs was detected in 60% of the malignant cases. Synchronous high GARP expression in tumor tissue and in the surrounding TILs was detected in 63.16% of the malignant cases yet, this result didn’t reach statistical significance.

Conclusion
GARP is a marker of Tregs, whose high expression is increased in malignant over benign and low-risk lesions. It might be a potential novel target for anticancer immunotherapy.
Component Restoration in the Unilateral Intermediate Cleft Lip Rhinoplasty: Technique and Outcomes
Authors: Albaghdady Ayman Ahmed , Ghanem Wael Ahmed , Soliman Mohamed Hisham , Shokry Shady Sheren , Mousa Ahmed Abdel Rahman 
Published: November 2024

Abstract

Background
The intermediate cleft tip rhinoplasty is performed in childhood to address residual tip asymmetries during the most critical period of psycho- social development. The authors describe and evaluate long-term outcomes of that approach for the unilateral cleft lip and palate patient based on the concept of individual restoration of each abnormal anatomical component.

Methods
This was a prospective comparative study in which the technique results were compared to age-matched unilateral cleft lip and palate control patients (n = 20). A separate group of unilateral cleft lip and palate patients who did not undergo intermediate cleft tip rhinoplasty were reviewed as control patients. Photographs of control patients were age-matched to each time point in the intermediate cleft tip rhinoplasty group. Technique of rhinoplasty was through an open approach. It was depending on restoration of the three main nasal cleft components; cartilage malposition, cartilage weakness and vestibular lining deficit. The authors here didn’t use cutaneous graft routinely to compensate the vestibular lining deficit. Instead, fine and complete dissection of the cleft side lower lateral cartilage from its vestibular lining before any cartilage repositioning. Standardized preoperative and postoperative basal view photographs were assessed at four time points: preoperatively (time 0), immediately postoperative (time 1), 3- 6 months (time 2), and more than 1 year postoperatively if available (time 3). Assessments of control and intermediate cleft tip rhinoplasty patients was carried out using four photo- morphometric relationships: Alar symmetry Nasal tip protrusion to alar base width, Cleft nostril dimensions, and Non-cleft nostril dimensions.

Results
Preoperative (time 0) baseline comparison between the study and the control groups showed significant differences regarding the nostril dimensions at the cleft side (P value 0.027) and alar symmetry (P value 0.000) denoting more severe deformity in the study group compared to the control group. At time 1, the study showed significant improvement regarding the alar symmetry (P value 0.000), and nasal tip protrusion (P value 0.004), while the changes regarding nostril dimension at the cleft side were non-significant (P value 0.057). At time 2, the study added significant improvement regarding the nostril dimensions at the cleft side (P value 0.049) that may reflect the importance of follow-up and using the nostril silicon retainer. At all times no significant changes regarding the nostril measures at non-cleft side were noticed.

Conclusion
The modified component restoration technique for the unilateral intermediate cleft lip rhinoplasty improves nasal relationships regarding alar symmetry, nostril dimensions at the cleft side, and nasal tip protrusion.
A Comparative Study between Early and Late Correction of Cases of Anorectal Malformation, Assessed by Fecal and Urinary Functional Outcome
Authors: Mahmoud Ahmed Himhamy , Naggar Osama Abdulellah El , Soliman Mohamed Hisham , Abo Halawa Nezar Abdelraof , Dahab Mohamed Mousa , Bersy Mohamed Ali 
Published: November 2024

Abstract

Background
Anorectal malformation (ARM) includes a wide spectrum of anomalies of the anorectal and urogenital region. They are not rarely associated with orthopedic, spinal, and neurologic abnormalities effecting the short- and long-term outcome. anorectoplasty at an early age is important for obtaining a better life quality in ARM patients.

Aim
Aim of the work to study defecation and urinary functional outcome according to timing of correction of ARM.

Patients and Methods
This was a cross sectional study conducted at patients with anorectal malformations (perineal fistula, rectourethral fistula, rectovesical fistula, vestibular fistula, no fistula, anal stenosis), at the Ain Shams pediatric surgery department and Qena pediatric surgery unit.

Results
bowel function and quality of life were significantly higher in early correction group compared to late correction group(p &lt; 0.001). The mean of the quality of life in the early and late correction groups was 12.83± 0.59 and 11.13± 2.73 respectively.

Conclusion
Early anorectoplasty and early appropriate bowel management is advisable, as that is essential for less fecal and urinary functional complications, and for proper life quality.
Comparative Study between Grafts and Flaps in Staged Repair of Primary Proximal Hypospadias
Authors: Elsadek Menan Ahmed , Abouzeid Amr Abdullhamid , Abd-El-BakyFahmy Mohamed , Dahab Mohamed Mousa , Abdullhamid Hazem Samir , Shokry Shady Sherin 
Published: November 2024

Abstract

Background
Choosing between flaps or grafts to substitute the urethral plate in 2-stage hypospadias repair has been a matter of debate with no consensus in the literature. Flaps have reliable blood supply that maybe theoretically less liable for strictures or contractures. Grafts are more versatile, which can be used in primary and recurrent cases when healthy local skin is deficient. In this report, our aim was to compare outcomes of grafts and flaps when used to substitute the urethral plate in two-stage repair of primary proximal hypospadias with ventral curvature.

Methods
This retrospective study included primary cases of hypospadias with significant curvature who underwent two-stage repair using either grafts or flaps to substitute the urethral plate in the first stage. Cases included in the study were divided into two groups according to the technique of substituting the urethral plate at the first stage of repair. During first part of the study period (2015 through 2018), we mostly used grafts to substitute the urethral plate (group A); later, we shifted to skin flaps (Group B) during the period 2019 through 2021.

Results
The study included 37 boys with primary proximal hypospadias who underwent two-stage hypospadias repair. The meatus position was penoscrotal in 18, scrotal in 16, and perineal in three. Inner preputial graft was used to substitute the urethral plate in 18 cases (group A), while dorsal skin flaps were used in 19 (group B). Out of the 37 cases, 27 were available at follow-up after second stage (group A = 14; group B = 13). Follow up period ranged between 6 and 42 months (mean 19.7; median 18.5). Overall, 14 cases required reoperations for different indications: partial disruptions of distal part of the repair in six, closure of urethro-cutaneous fistula in six, and urethral strictures in two. The rate of complications was higher in group A (10 cases: 71%) compared to group B (4 cases: 31%) (Fisher exact test, p-value = 0.057).

Conclusion
Grafts were associated with higher complication rate than flaps when used to substitute the urethral plate in two-stage repair of proximal hypospadias with chordee. Type of Study and Level of Evidence. This is non-randomized comparative study (level III evidence).
Frequency of Delayed Puberty among Adolescent Females with Type 1 Diabetes
Authors: El Samahy Mona Hussein , El-din Nouran Yousef Salah , Mahmoud Rana Abdelhakim Ahmed , Mohamed Asmaa Khalifa Radi 
Published: November 2024

Abstract

Background
Female patients with T1DM may display menstrual disturbances, hyperandrogenism or early menopause at certain moments of their lives, thus representing a significant health problem.

Objective
To detect the frequency of delayed puberty among a cohort of Egyptian adolescent females with type 1 diabetes mellitus (T1DM).

Methods
This cross sectional study examined 175 adolescent females with T1DM aged(14-18)years following up at the Pediatric and Adolescents Diabetes Unit, Ain Shams University for delayed puberty. History taking with complete physical examination was done including: Tanner staging (delayed puberty was defined as puberty occurring two standard deviations beyond the mean age). Girls were evaluated for delayed puberty in the following situations: (1) no breast development by age 13, (2) no menarche within 3 years of the larche, (3) no menarche by age 14 with signs of hirsutism, (4) no menarche by age 14 with history or examination suggestive of excessive exercise or eating disorder, and (5) no menarche by age 15 (ACOG committee opinion, 2015). Clinical manifestations of insulin resistance, blood pressure and anthropometric measures were assessed with calculation of the z score for age and gender. Laboratory assessment including fasting glucose, HbA1C, fasting lipid profile was done.

Results
Delayed puberty was found in 6.3 % of the studied adolescent females with T1DM. Mean age at menarche was 13.2 years and the percentage of tanner V was 28 % of this cohort. Mean age was negatively correlated with delayed puberty, while duration of DM, waist circumference Z score, waist/hip ratio Z score and mean of LDL were positively correlated with delayed puberty. No significant relation was found with HbA1C, fasting glucose, cholesterol, triglyceride, HDL

Conclusion
Although uncommon, delayed puberty can be seen in girls with T1DM. It is correlated to glycemic control and hyperlipidemia.
Effect of a Hemodialysis Session on Intercellular Adhesion Molecule-1 (ICAM-1) in Children with Chronic Kidney Disease Stage 5 on Regular Hemodialysis
Authors: Dahshan Doaa R , Kasem Mohammed F , Mohammed Noha R , Said Ragia M 
Published: November 2024

Abstract

Background
During hemodialysis (HD) session leukocytes are activated and a number of proinflammatory cytokines and adhesion molecules are secreted. One of these adhesion molecules is intercellular adhesion molecule-1 (ICAM-1). ICAM-1 is a cell surface glycoprotein adhesion receptor responsible for regulating leukocyte recruitment from the circulation to sites of inflammation. It is incriminated in the endothelial cell injury in HD patients making them at risk of cardiovascular complications.

Objective
To assess the effect of a single HD session on the level of circulating ICAM-1 in children with chronic kidney disease stage 5 (CKD-5) on regular HD treatment.

Methods
This is a cross sectional study done at Pediatric Dialysis Unit (PDU), Children’s Hospital, Ain Shams University during the period from April 2023 to July 2023. It included 26 CKD-5 cases and 26 age and sex matched children as controls. CBC, CRP and serum ICAM-1 (ELISA) were done for all cases pre-HD. CBC and serum ICAM-1 were repeated for all patients post-HD. CBC, CRP and serum ICAM-1 were also done for controls.

Results
This study comprised 26 cases with mean age of 12.2±2.8 years. They were 16 males (61.5%) and 10 females (38.5%). All cases were receiving 3 hours HD session 3 times per week using low flux polysulfone dialyzer. It also included 26 controls with mean age of 10.9±2.7 years. They were 13 males (50%) and 13 females (50%). Cases and controls were age and sex matched. Our results revealed statistical evidence of significantly elevated pre-HD (Median= 676.6ng/L, IQR= 932.1ng/L) and post-HD (Median= 1749.5ng/L, IQR= 1812.5ng/L) serum ICAM-1 compared to its level (174.6 ±55.5ng/L) in controls (p &lt; 0.001 for both). There was also statistical evidence of significantly higherlevel of post-HD serum ICAM-1 than its pre-HD one (p = 0.001). This study did not show any statistical evidence of significant differences in ICAM-1 levels regarding gender, dialyzer surface area, pump blood flow rate and the presence of hypertension. It did not also reveal any statistical evidence of significant correlations between ICAM1 and any of the studied variables including age, duration of HD and the parameters of CBC especially TLC, ANC & LC.

Conclusion
children with CKD-5 on regular HD had higher basal levels of serum ICAM- 1 than normal controls. These levels were further increased after HD session using low flux polysulfone membrane.