bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of Medication Errors and Most Common Drugs Involved during Management of Isolated Patients with COVID 19 in an Egyptian General Hospital
Authors: Mostafa Alaa Mohamed , Fahim Al Tehewy Mahi Mahmoud , Gaafary Maha El , Basyoni Nashwa Ismail 
Published: November 2024

Abstract

Background
The second wave of the COVID-19 pandemic presented significant challenges to healthcare systems worldwide. This retrospective cohort study aimed to investigate incidence and type of medication errors among patients isolated in an Egyptian general hospital during the early months of 2021.

Methods
A total of 468 patient records were reviewed for medication errors. Data collection included patient demographics, comorbidities, admission details, and clinical pharmacist data. Medication errors were categorized based on ordering, administration, and monitoring processes. Statistical analysis included descriptive statistics, and visual representations of key variables.

Results
A total of 934 medication errors were found with a prevalence of 42 per 100 patient days and almost 2 errors per patient. All participants experienced drug therapy problems, with the most prevalent issues related to dosing regimen (31%), needs drugs (27%), and monitoring (18%). The main drugs involved in medication errors were anticoagulants (17.6%), antibiotics (12.3%), corticosteroids (10%) and antiviral drugs (9%).

Conclusion
This study highlights the very high incidence of medication errors among COVID-19 patients during the second wave of the pandemic. The main issues were related to “dosing regimen”, “needs a drug” and “needs monitoring”. Also, the main drug groups involved in theses errors were anticoagulants and antibiotics, followed by corticosteroids and antiviral drugs.

Recommendations
Addressing medication errors, especially in critical care settings, is crucial for improving patient safety and outcomes. Future interventions should focus on enhancing healthcare professionals' knowledge and communication, particularly in high-stress environments like ICUs. These findings can guide healthcare practice improvements and enhance patient care during pandemics and other healthcare crises.
Role of High-Resolution Ultrasound in Assessment of Median and Ulnar Nerve Lesions
Authors: Abdeldayem Ahmed Hassan Mohamed , Botros Ibrahim Samer Malak , Sabry Kareem Ahmed Abdelaziz , Fahmy Marwa Ibrahim 
Published: November 2024

Abstract

Background
Peripheral nerve disorders happen when one or more peripheral nerves are damaged. Damaged nerves may not carry messages correctly, or they may not work at all. As a result, you may have pain, trouble walking, or a variety of other problems, depending on which nerves are involved. Peripheral nerve disorders are very common. There are more than 100 different types.

Aim
To detect the value of high resolution ultrasound in assessment and characterization of some median and ulnar nerve lesions, Including, mainly, compressive, traumatic and inflammatory nerve injuries.

Patients and Methods
26 participants were included in our study either from outpatient clinics (neurology, rheumatology and diabetic clinics) or inpatient wards (vascular surgery department). The study was designed as a case series study; we studied 26 cases with diabetic peripheral neuropathy, carpal tunnel syndrome and traumatic/neoplastic nerve lesions. All selected cases were subjected to proper history taking and ultrasound detection of cross-sectional area (CSA) measurements of median/ulnar nerves in cases of diabetic peripheral neuropathy/carpal tunnel syndrome, compression/flattening of median nerve in cases of carpal tunnel syndrome, loss of integrity in traumatic nerve lesions and neuroma incontinuty in traumatic/neoplastic nerve lesions.

Results
Regarding the ultrasound findings of the peripheral nerves (median/ulnar nerves), there were 38.5% cases were carpal tunnel syndrome, 23.1% were ulnar nerve diabetic neuropathy and 3.8% were complete tear of digital branch of median N, median N complete transection with neuroma, median N entrapment by scar tissue, median N injury neuroma old crush injury, median N injury with neuroma in continuity, median N injury with small hematoma& bifid median N, median ulnar nerve traumatic injury, ulnar nerve crush injury neuroma, ulnar nerve penetrating wound neuroma and ulnar nerve shwanoma. We found that there are significant increase in ulnar/median nerves CSA among diabetic patients with diabetic peripheral neuropathy (DPN)/patients with carpal tunnel syndrome (CTS), compression/flattening of median nerve in patient with CTS, loss of integrity in cases of traumatic nerve lesions and neuroma incontinuty of traumatic/neoplastic nerve lesions.

Conclusion
High resolution ultrasound of median and ulnar nerves proved very helpful in the early diagnosis and distinction of various median and ulnar nerves lesions seen in patients with carpal tunnel syndrome, ulnar nerve diabetic neuropathy clinically suspected, patients with median/ulnar nerves traumatic lesions and patients with ulnar nerve neoplastic nerve lesions. Upper limb peripheral nerve ultrasonography can serve as a useful diagnostic tool in the diagnosis of peripheral nerve lesions.
Clinical Value of Deep Gray Matter 3T MRI Perfusion in Patients with Multiple Sclerosis
Authors: Metwaly Ahmed Mohammed Rezk , Amin Sherin Kadry , Abdelrahman Ahmed Samy , Kamal Teiba Mohamed 
Published: November 2024

Abstract

Background
Multiple sclerosis is one of the most common non traumatic neurological disorders between adults. Magnetic resonance imaging is the most sensitive imaging modality for assessment of multiple patients. New MRI techniques have been improved which help in more accurate assessment of the disease extent, activity, severity and treatment prognosis. Recently, advanced quantitative MRI techniques have detected micro-structural alterations even in the normal appearing white and gray matter of multiple sclerosis patients. In dynamic susceptibility contrast MRI perfusion, the tissue perfusion is assessed by evaluation of a series of rapidly repeated T2*-weighted MR images resulting from the first pass of a contrast agent bolus through the tissue.

Objective
To highlight the role of MRI perfusion in detection of deep gray matter perfusion alteration in multiple sclerosis patients and its relation to the clinical disability and cognitive impairment

Methods
40 patients who were proven as multiple sclerosis patients clinically were enrolled in this study, fulfilled the inclusion criteria. They were divided into two groups (group A with mild clinical disease and preserved cognitive functions, and group B with marked clinical disease and cognitive functions impairment) they were divided according to their clinical disability and cognitive functions status assessed by single experienced neurologist blind to the MRI findings, Additional 20 normal control cases in the same age group were included in the study. Perfusion parameters including cerebral blood volume, cerebral blood flow and mean transit time of the deep gray matter were compared for healthy controls and for the two study groups.

Results
The cerebral blood flow, cerebral blood volume and mean transit time values averaged over the thalamus, putamen, and caudate nuclei were significantly changed in group B (marked clinical disease with cognitive functions impairment) that shows marked decrease in perfusion parameters (cerebral blood volume and flow) and increased mean transit time compared with group A (mild clinical disease with no cognitive functions impairment) and the controls, With respect to group (A), there was no significant difference between the patients and controls

Conclusion
The decrease of tissue perfusion in the deep gray matter of patients with multiple sclerosis is associated with the severity of the clinical disease and cognitive impairment.
Diagnostic Performance of Abbreviated MRI Protocol for Colorectal Liver Metastasis Compared to Dynamic MRI Protocol
Authors: Ragaey Alaa Ahmed , Diaa ElDeen Mohammad Noha , Mostafa Mai Ahmed Mostafa 
Published: November 2024

Abstract

Background
Colorectal cancer is the 7th commonest cancer in Egypt, representing 3.47% of male cancers and 3% of female cancers. New treatments and the technological improvements of imaging increase the detection of secondary lesions and consequently improve the survival of these patients. Imaging is an important tool in the management of patients with liver metastases by evaluating and following up the lesions regarding the number, size, site and assessing the resectability. Ultrasound and contrast-enhanced computed tomography (CECT) were the first-line imaging tools for the assessment of metastatic liver lesions. However, these modalities have a low sensitivity and specificity for the detection and characterization of liver lesions. These limitations have paved the way for contrast-enhanced magnetic resonance imaging (CE-MRI), which has now become the modality of choice in triaging patients with suspected colorectal liver metastasis. Abbreviated MRI protocols have emerged as an alternative to standard MRI protocols thus eliminating unnecessary sequences that increase the cost, MRI table time, patient discomfort, and image interpretation time. However, the diagnostic competency is not generally compromised. The purpose of our study is to assess whether an Abbreviated MRI protocol consisting of DWI and T2-W fat- suppressed (FS) sequence has a similar lesion detection performance compared with standard gadoxetic acid–enhanced MRI protocol for colorectal liver metastasis surveillance.

Results
we found in our study that in the detection of hepatic metastasis in colorectal cancer, abbreviated protocol showed 92.86% sensitivity, 93.55% specificity, 86.67% PPV, 96.67% NPV, and 93.33% overall accuracy. Also, the complete protocol showed 100% sensitivity, 96.8% specificity, 93.3% PPV, 100% NPV, and 97.8% overall accuracy.

Conclusions
A comparison between abbreviated and complete protocols showed in the detection of hepatic metastasis in colorectal cancer that the complete protocol had higher sensitivity, specificity, PPV, NPV, and accuracy than the abbreviated protocol. However, these differences did not reach a significant level (p &gt; 0.05).
Added Value of Diffusion-Weighted Magnetic Resonance Imaging in Evaluation of Musculoskeletal Soft Tissue Masses
Authors: Helal Ayman Amgad , Sakr Hossam Moussa , Elsayed Samar Shehata Mohamed 
Published: November 2024

Abstract

Background
Magnetic Resonance Imaging is the method of choice for the diagnostic work- up of soft tissue tumors. It is the modality of choice to evaluate such masses, because of its excellent soft tissue contrast. Although there are some findings are indicative for malignancy, such as infiltration of adjacent tissues, destruction of bones and tendons, and the size of the mass, there are no criteria available to clearly distinguish benign masses from malignancies.

Aim of the Work
To evaluate the added value of diffusion-weighted magnetic resonance imaging in detection and characterization of musculoskeletal soft tissue masses.

Patients and Methods
This study is a cross-section hospital based retrospective study. This study conducted at Ain Shams University Hospitals. The main source of data for this study was the PET/CT scans and clinical history of the patients referred to the department of Radiology, Ain Shams University Hospitals and the period of the study is 12 months.

Results
Mean of enrolled patients was 37.1 ± 18.0 years and majority (72%) of them was females. It was noticed that thigh (28%) was frequently affect in the those patients followed by the leg (20%). Mean size of these masses was 101.14 ± 78.87 mm. based on histopathological evaluation of these mass; 15 (60%) masses were benign while malignant mass present in 10 (40%). Lipoma and Dermoid fibromatosis were the most frequent tumors in the current study (12%) following by Neurofibroma, Osteosarcoma, Sarcoma and Synovial sarcoma each one of them is (8%). Patients with malignant lesions had significantly lower ADC value in comparison to those with benign lesions (0.78 ± 0.09 vs. 1.56 ± 0.55 (10-3 mm2/s). Haemangiomas had the highest ADC value that was (2.35 ×10 − 3mm2/s.) while sarcoma had lowest value that was 0.54 ± 0.03 (103 mm2/s). It was noticed that MRI had 100% sensitivity and 93.3% specificity for diagnosis of malignant musculoskeletal soft tissue masses with overall accuracy was 96% and area under curve was 0.96 at cut off value was &lt; 1.14 (103 mm2/s). Based on final diagnosis; MRI was successful in diagnosis of all cases with malignant musculoskeletal soft tissue masses but as the same time, MRI falsely diagnosed one case with benign nature to be malignant. Those one case was finally diagnosed to be lipoma.

Conclusion
The ability to differentiate benign musculoskeletal soft tissue tumors from malignant disease is limited clinically. Magnetic resonance imaging is an established modality for comprehensive diagnosis of musculoskeletal tumor. A non-invasive technique is needed to obtain information about the function of the tissue of interest. Diffusion-weighted (DW) MRI is an advanced technique used in combination with MRI to improve its diagnostic accuracy.
The Relationship between Vertebrobasilar Circulation Anatomic Variations and Posterior Fossa Stroke
Authors: Saber Hamad Ayman Mohamed , Taha AbdelAziz Tougan , Teiba Mohamed Kamal Ahmed 
Published: November 2024

Abstract

Background
Posterior circulation stroke accounts for 20% of all ischemic strokes and carries a high mortality up to 85%, posterior circulation includes vertebral, basilar arteries and their branches, anatomical variations are very common in the posterior circulation, in particular vertebral arteries, the most common variant is asymmetry, left vertebral artery dominance presents in 50% of the population, right vertebral artery dominance presents in 25% of the population while similar size vertebral arteries present with an only 25% prevalence, other variations of vertebral artery include fenestration and they may vary in origin. Basilar fenestration is the most common intracranial arterial fenestration and the most common congenital anomaly of the basilar artery. This anatomic variation is characterized by duplication of a portion of the artery that is connected proximally and distally, which may predispose to basilar artery aneurysm formation, other variants include persistent carotid-vertebrobasilar anastomoses and basilar artery hypoplasia, anatomic variation of posterior cerebral artery includes fetal posterior cerebral artery incidence reaches 15%, other variations include fenestration.

Objective
To determine the relationship between anatomic variations of the vertebrobasilar circulation and posterior fossa stroke in patients who underwent MRI brain stroke protocol at our MR unit for evaluation of ischemic stroke.

Patients and Methods
This study was a retrospective study, and the study was conducted at Ain Shams University Hospitals, radio diagnosis department. The study period 7 months. Including sample of 50 Patients radiologically diagnosed with posterior fossa stroke.

Results
There was a significant ratio of posterior fossa anatomic variations especially vertebral artery hypoplasia in patients with posterior fossa stroke reaching 66%

Conclusion
In our study, we demonstrate the high incidence of posterior fossa anatomic variations in patients with posterior fossa stroke.
Diagnostic Accuracy of Contrast Enhanced Spectral Mammography in Assessment of Indeterminate Breast Lesions in Patients after Breast Conservation Surgery
Authors: Shaban Dalia Ahmed Mohamed , Boraei Azza Abdel Ghaffar , Chalabi Nivine Abd Elmoneim Tawfik , Ali Nagi Mona Ali Mohamed 
Published: November 2024

Abstract

Background
Breast cancer in women represents a major public health problem being the most common cancer among women in both developed and developing countries, it accounts for 22.9% of all new female cancers. In Egypt breast cancer accounts for 37.7% of the total new cancer cases. Contrast Enhanced Spectral Mammography (CESM) is an emerging advanced technique that depicts breast tumor angiogenesis. CESM has higher diagnostic accuracy compared to MG with or without US and can depict tumor neovascularity in an analogue manner to breast MRI.

Aim of Work
To evaluate the diagnostic accuracy of contrast enhanced spectral digital mammography in assessment of indeterminate breast lesions in patients after breast conservation surgery.

Patients and Methods
30 female patients underwent breast conservative surgery presenting with indeterminate breast lesion on mammography had been evaluated by dual-energy contrast enhanced spectral mammography. The age ranged from 32 to 77 years (mean=50.07). Results of histopathological examinations of surgical or biopsy specimens were obtained and served as the gold standard.

Results
The surgical and pathological results of our patients revealed 23/33 (69.7%) benign lesions and 10/33 (30.3% malignant lesions. CESM had a sensitivity of 88.9%, a specificity of 83.3%, a positive predictive value of 66.7%, a negative predictive value of 95.2%.

Conclusion
CESM is a promising tool for increasing the sensitivity and the diagnostic accuracy of conventional mammography in follow-up of patients with breast conservative surgery.
Role of Ultrasonography and Color Doppler versus Nerve Conduction Test Results in Evaluation of Cases of Carpal Tunnel Syndrome
Authors: Geneidi Eman Ahmed Shawky , Shalaby Mennatallah Hatem , Morshedy Dina Mohsen Abdelrahman 
Published: November 2024

Abstract

Background
Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with incidence rate of 2.7 to 5.8% of the general population. Nerve conduction studies (NCS) were considered gold standard for diagnosis. Due to false negative rate, Ultrasonography (US) evaluation of median nerve (MN) was suggested as a diagnostic test for CTS.

Aim of the Work
Our aim was to investigate the diagnostic accuracy of US derived measurements compared to NCS for the diagnosis of CTS and comparing different US derived measurements and ratios to know which could be used efficiently for the diagnosis of CTS.

Patients and Methods
This case control study included 52 participants; 26 cases and 26 healthy controls. Our results showed comparable sensitivity between US and NCS results which was 88% and 96.2, respectively. On the other hand, specificity with US measurements was 92% compared to 88% in case of NCS.

Results
Many US derived measurements as inlet MN CSA, outlet CSA, largest CSA between inlet and outlet, WFR and IOR showed statistically highly significant correlation with clinical diagnosis of CTS. Other measurements like CSA at proximal border and proximal third of pronator quadratus muscle failed to show statistically significant correlation.

Conclusion
US results are comparable to NCS results in cases of CTS. US derived measurements as MN CSA at carpal tunnel inlet and largest CSA between inlet and outlet were best to be used for correlation with clinical diagnosis with cut-off value = 9.35 and 9.3 cm2, respectively. WFR and IOR have also high correlation with clinical diagnosis with cut-off value = 1.1 and 1.02, respectively.
MRI Correlation between Lumbar Disc Herniation and Multifidus Muscle Degeneration
Authors: Mohie Eldin Mounir Dina Sherif , Gomaa Elsharkawy Mohsen , Elhoda Passant Abo 
Published: November 2024

Abstract

Background
The lumbar multifidus muscle (LMM) is the largest group of posterior muscles in the lumbosacral region. it specifically acts to maintain segmental stability of the spine, maintain lumbar physiological lordosis, control facet joint movement, and adjust the distribution of the intervertebral load and pressure, this study is to investigate if correlation could exist between multifidus muscles degeneration and lumbar disc herniation (LDH), that may be a process of mutual influence and interaction.

Aim of the Work
To investigate the correlation between lumbar disc herniation (LDH) and multifidus muscle degeneration via the comparison of the cross-sectional area and degree of fatty infiltration of the lumbar multifidus muscle.

Patients and Methods
This study is a retrospective study. The study will be conducted at Ain Shams University Hospitals. The main source of data for this study will be the retrospectively conducted scans and clinical history of the patients referred to the department of Radiology, Ain Shams University Hospitals.

Results
the patients with ULDH are significantly different from healthy people in the measurement indexes of the multifidus muscles. Moreover, the mean and range of relevant indicators are smaller. The results indicate that multifidus muscle atrophy is closely related to upper lumbar disc herniation. both the cross-sectional area and the degree of fatty infiltration exhibited excellent evaluation efficiency. Clinical practice had often neglected the paravertebral muscles, and it was not well protected during spinal surgeries in the past. This study also confirmed that there is significant atrophy of the multifidus muscle in patients with ULDH. Future clinical practise should emphasise on the negative effects of multifidus muscle atrophy. Reinforcing the lumbar spine muscles can help improve this atrophy, which could benefit the prevention and rehabilitation of ULDH.

Conclusion
A relationship could exist between multifidus muscles degeneration and ULDH entailing a process of mutual influence and interaction; however, prospective studies should confirm this. Evaluation of multifidus muscles should be considered when using MRI scans to assess the ULDH patients. Lumbar muscle strengthening training could prevent and improve muscle atrophy and degeneration.
Role of Magnetic Resonance Spectroscopy in Dementia
Authors: Ismail Salwa Taha Ahmed , Geneidi Eman Ahmed Shawki , Ekladious Mena Elerian Youssef , Elgawad Marwa Abd Elazeem Abd , Arab Enas Arafa Anwar 
Published: November 2024

Abstract

Background
Dementia is becoming a significant public health problem of the century due to increasing life expectancy and aging populations around the world. The most common pathology underlying dementia in older adults is Alzheimer’s disease (AD). vascular dementia and Lewy body disease pathologies are other common causes of dementia in the elderly and in many instances AD is also present in patients with dementia with Lewy bodies (DLB) and vascular dementia (VaD). A relatively less common type of dementia is frontotemporal lobar degeneration (FTLD), which tends to affect younger individuals compared to other dementia pathologies.

Aim of the Work
Aim of the work is to identify the role of MRS in common dementia. Ethical considerations: Oral approval from the patients or responsible relatives were obtained after explaining the procedure to them, the study was conducted according to the stipulations of ASU ethical and scientific committee.

Patients and Methods
Our study included 36 patients diagnosed as dementia patients clinically, fulfilled the inclusion criteria. They were 22 females and 14 males; their ages ranged from 40-89 years with the mean age 68 years in addition to 13 healthy control cases in the same age group 7 females and 6 males, their ages ranged from 50 to 75 years.

Results
In our study, The most remarkable findings was reduction of cerebral volume in most of the patients in all types of dementia. NAA peak in dementia patients was reduced compared to the control groups with more reduction was noted in the Alzheimer’s group indicating demyelination with progressive neural and axonal damage. The Myoinositol increase is indicator for glial cell proliferation and gliosis. It’s peak was expected to be increased, however in our study it shows increased level in patients with advanced AD only, no significant change compared to the control group in other types of dementia or early diagnosed patients with Alzheimer’s disease.

Conclusion
Our study showed significant reduction of cerebral volume as well as some metabolic changes that proves that MRS is a non invasive imaging tool can be used to identify dementia after more researches to find disease specific changes.