bluuebunny/crossref_metadata_2025_split huggingface dataset:
Targeted Muscle Reinnervation in the Hand for the Prevention and Treatment of Symptomatic Neuroma Following digit and Hand Amputations, A Prospective Case Series
Authors: Fathy Aly Howeidy Ayman Ibrahim , Attiya Aly Ahmed Naeem , Diab Ramy Ahmed , Mohamed Aly Amr Moustafa , Aly Soliman Ramy Ahmed , Fouad Mohamed Mohamed Magdy Ahmed 
Published: November 2024

Abstract

Background
Neuromas are a common complication after digital and hand amputations, resulting in significant pain, discomfort, and functional impairment. Various management methods are available, including surgical excision, nerve blocks, and nerve stump protectors, but these treatments may have limited success rates and potential complications. Targeted muscle reinnervation (TMR) is a promising technique that involves surgically rerouting a severed nerve into a nearby muscle, which can prevent the formation of neuromas and provide improved muscle function.

Aim of the Work
The aim of this work is to assess the efficacy of Targeted muscle reinnervation in the treatment and prevention of symptomatic neuromas in digit and hand amputations, to evaluate the surgical technique and to record any possible postoperative complications or improvements of the technique in the hand.

Materials and Methods
We conducted a prospective case series at Ain Shams University hospitals, we recruited 20 patients eligible for our study by our criteria with digit or hand amputation distal to the wrist crease or a symptomatic neuroma within the hand or digits starting from August 2021 and for 24 months. We excluded patients with cognitive impairment for better outcomes assessment and patients below 18 years old. Either 1ry or 2ry TMR was performed on each patient.

Results
It has resulted in remarkable improvement in the neuroma pain experienced by our hand trauma patients and showed a promise as both a therapeutic and preventative tool to reduce the formation of symptomatic neuromas.

Conclusion
The technique requires good knowledge of hand microsurgical anatomy and good training in microsurgery, we observed a decrease in the operative time towards the conclusion of the study which proves the learning curve. TMR has minimal morbidity and is easily reproducible as demonstrated by multiple surgeons performing the surgery with consistent results.
Comparison between Intramedullary K Wires versus Mini Plate Fixation in Isolated Displaced Shaft Lesser Metatarsal Fractures
Authors: Farouk Amr , Koriem Islam , Mashaly Shehab Mahmoud Abdelhamid 
Published: November 2024

Abstract

Background
Metatarsal (MT) fractures are common foot injuries and account for almost half of all foot fractures. The five metatarsals are the biggest bones in the forefoot and are essential for weight bearing in the last stages of the stance phase.

Objective
to compare between intramedullary K wires versus mini plate fixation in isolated displaced shaft lesser metatarsal fractures regarding the time and rate of fracture healing, as well as the functional outcome of the surgically treated and American Orthopedic Foot and Ankle Society (AOFAS) functional score for the forefoot and related complications of each fixation method. The objective is to perform a systematic review of comparison between intramedullary K wires versus mini plate fixation in isolated displaced shaft lesser metatarsal fractures.

Patients and Methods
This study was conducted following the preferred items for systematic review meta-analysis (PRISMA) to answer the question of which is better k-wire intramedullary nailing fixation or Open reduction and internal fixation with plate and screws according to the AOFAS score and time until union and complications.

Results
Our study represents that fixation techniques by K-wire intramedullary nailing has statistically significant superiority of surgical treatment for lesser metatarsal acute shaft fractures. Optimal reduction and fixation of the fracture with less surgical insult can be achieved by K-wiring, leading to a significantly quicker recovery as a comparison with the plate and screws fixation. Open reduction and internal fixation with plate and screws are accompanied with prolonged healing period, longer timeline of rehabilitation and hardware discomfort.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021.

Conclusion
Lesser metatarsal fractures with good prognosis have been well treated by percutaneous closed antegrade intramedullary pinning in di placed fractures because it offers immediate mobilization of the joint and partial weight-bearing in a stiff-soled shoe. In elite injured personnel as athletes and dancers etc., they need special methods of rehabilitation depend on the patient’s career and his or her available period of rehabilitation. Open reduction and internal fixation with plate and screws are accompanied with prolonged healing period, longer timeline of rehabilitation and hardware discomfort.
Evaluation of Candidate Antischistosomal Drugs in a Murine Model of Schistosomiasis Mansoni
Authors: Hussein Hesham M , Sayed Samia W Abdel , Shehata Mai A , Mohammad Omnia S , Mohamed Ghada A 
Published: November 2024

Abstract

Background
Schistosomiasis is a neglected tropical disease with a considerable morbidity. Despite being safe and efficacious, praziquantel (PZQ) does not prevent reinfection. In addition, the emergence of drug resistance is of a great concern.

Objectives
The current study was performed to evaluate the therapeutic efficacy of amiodarone, spironolactone, and combinations of drugs on S. mansoni- infected mice compared to PZQ through parasitological and histopathological parameters.

Methodology
Mice were divided into 2 major groups: early treated group (3 weeks post-infection) and late treated group (6 weeks post-infection), Each mouse was examined for total worm burden, tissue egg load, oogram and histopathological granuloma formation.

Results
For the early-treated group, spironolactone had the best therapeutic outcome considering its effect on the total worm burden, ova count, oogram pattern and liver granuloma parameters. Whereas, for the late-treated group, amiodarone combined with PZQ added to the effect of PZQ alone on the total worm burden, ova count, oogram pattern and liver granuloma parameters.

Conclusion
It is concluded that spironolactone and amiodarone have considerable antischistosomal effects. Spironolactone was superior to PZQ and amiodarone in the early treatment phase targeting the immature stages. Meanwhile, amiodarone had a synergistic effect when combined with PZQ in the late treatment phase targeting the mature schistosomes. The current work recommends further investigations considering drug combinations strategy for the treatment of intestinal schistosomiasis with different doses and durations.
Evaluation of TRPS1 as a Diagnostic Marker for Breast Carcinoma
Authors: Mohamed Sarah S , Helal Thanaa , Nada Ola , Elgohary Shimaa A 
Published: November 2024

Abstract

Background
Breast cancer (BC) is a very important health challenge worldwide. It is the leading cause of global cancer incidence and the leading cause for cancer related mortality in women. BC is a disease with high metastatic potential always a suspect in the differential diagnoses of metastatic carcinoma of unknown primary. Based on the expression of ER, PR, Her2 BC is categorized into molecular subtypes as luminal (A&B), Her2-postive and triple negative (TNBC) subtypes. TNBC is the most aggressive form with high tendency for metastasis and overall poorer clinical behavior. Diagnosis of metastatic TNBC breast cancer is usually a diagnostic dilemma due to absence of sensitive and specific immunohistochemical marker for breast origin. Trichorhinophalangeal syndrome-1 (TRPS1) is a recently discovered breast marker with high expression in different molecular groups especially TNBC, making it a potential useful tool for diagnosis of BC.

Objective
To evaluate the immunohistochemical expression of TRPS1 in breast carcinoma as a highly sensitive and specific marker for breast carcinoma, especially for TNBC.

Methods
The current study was conducted retrospectively on 80 cases of invasive breast carcinoma as archived formalin fixed paraffin embedded blocks obtained the Pathology Department lab of Ain Shams University Hospitals (2019-2023). The cases included in the current study were divided into 3 groups; Group 1: included 25 Luminal cases, Group 2: included 20 Her-2 positive cases and Group 3: included 35 TNBC cases. Data concerned with gender, age and type of procedure were obtained from the electronically archived reports. The histopathological data were re-examined microscopically by at least two authors. After then, the expression of TRPS1 was evaluated in different molecular groups, followed by statistical evaluation of the obtained results.

Results
TRPS1 was expressed in 88.8% of the studied cases. No statistically significant relationship between TRPS1 expression and the histopathological subtype, tumor size, tumor grade, lymph node status nor in-situ duct component. TRPS1 high score was detected in 66.3% of the studied cases. TRPS1 showed high expression in different molecular groups, as it was detected in 96% of luminal group, 85% of Her2-positive group and 85.7% of TNBC group. These differences were not statistically significant.

Conclusion
TRPS1 is a sensitive marker for all molecular subtypes of breast cancer. It might be a valuable addition to determine breast origin in clinical practice especially for TNBC.
Rectal Colonization Study and its Impact on Blood Stream Infection in Hospitalized Pediatric Oncology Patients
Authors: Ragab Iman , Gawad Amira NAbdel , Anwar Maha Ahmad , Soliman Ahmed Adly Abd-El Hamied 
Published: November 2024

Abstract

Background
Colonization with multidrug resistant organisms (MDRO) is associated with bacterial translocation, which can result in subsequent endogenous blood stream infection (BSI) with high morbidity and mortality. Surveillance rectal swabs can aid in the choice of empiric antimicrobial during episodes of neutropenic fever.

Aim
To compare types of organisms and prevalence of MDRO obtained from both surveillance rectal swabs and blood cultures among leukemia patients with BSI.

Methodology
we conducted a 6 month-cross-sectional observational study that included 45 patients with acute leukemia during hospital admission at the pediatric hematology/oncology inpatient ward, Ain Shams University, with review of any antimicrobial intake or hospital admission in the last 3 months before initial presentation. Surveillance rectal swab were done upon 1st admission before start of antimicrobials. Repeat surveillance swabs with any subsequent admission, complete blood counts (CBC) and blood culture were withdrawn with the 1st febrile episode, antimicrobial susceptibility were assessed by disc diffusion.

Results
The mean (±SD) age of the studied cohort was 6.84 (±3.16) years, 60.0% were B-ALL, 31.1% AML and 8.6% T-ALL. Nine patients (n = 20.0%) received antibiotic prior to admission. Seventeen patients (37.7%); including n = 3 (18.7%) with prior antibiotic intake; had initial positive rectal swab with 94.1% with gram negative resistant strains (GN R), 56.2% of them were extended spectrum beta lactamase (ESBL), 25% MDRO Carbapenem sensitive and 18.7% carbapenem resistant. With development of febrile episode, 48.8% developed bacteremia with 45.4% showed growth of GN R, among which 13.6% demonstrated same type of organism and pattern of resistance of surveillance swab. As for follow up surveillance swabs only 11.6% had positive swabs, with only 1 patient (5.8%) was persistently positive for the same GN R organism as the initial swab.

Conclusion
Rectal colonization are present in high frequency in children with cancer at diagnosis, many of them were gram negative resistant strains. The same types of organism in rectal swab and BSI are encountered in the majority of neutropenic patients, which needs to be identified for proper empiric antimicrobial selection during febrile episodes.
Hemodynamic Monitoring of Stable Neonates Using Electrical Cardiometry in Comparison to Functional Echocardiography, A Cross-Sectional Study
Authors: ElSayed Eman Mohamed , EL-Farrash Rania Ali , Kamal Ahmed Hamdy , Saleh Ghada Ahmad 
Published: November 2024

Abstract

Background
Hemodynamic monitoring is an essential component in the care of term and preterm infants in neonatal intensive care units (NICUs). Echocardiography (Echo) can provide real time assessment of cardiac function, loading conditions (preload and afterload) and cardiac output (CO), but it requires training and can only be obtained intermittently. Electrical cardiometry (EC) has been approved by FDA as a safe, non-invasive, accurate and reproducible technique for hemodynamic assessment in children and infants.

Aim of the Work
To evaluate the accuracy of the electrical cardiometry in comparison to functional echocardiography in hemodynamically stable neonates.

Patients and Methods
This cross-sectional agreement study was conducted in NICUs of Children hospital of Ain Shams University, between (01/03/2021- 31/08/2021), and was approved by the Ethics committee of Ain Shams University (approval no: - MS 336\2021). Hemodynamically stable neonates admitted during the study period were eligible for enrollment and were included if their age was less than 7 days. Neonates with congenital anomalies, those requiring or recovering from surgeries and those with sever neonatal sepsis were excluded.

Results
Ninety neonates were included (55.6% females, 44.4% males), (41 preterm, 49 full term). In all study population, there was positive correlation between EC and Echo for heart rate, stroke volume, cardiac output, and cardiac index (p-value &lt;0.001 for all). For EC readings for all patients, Cardiac Performance Index (CPI) mean was 0.41 (ranged from 0.23 to 0.65 W/m2), Stroke Volume Variation (SVV) ranged from 10 - 40% with mean 18.53 %, Systemic Vascular Resistance Index (SVRI) range from 608 to 2886 dyn-sec/m2 (mean of 1482.2 dyn- sec/m2), and Total Fluid Content (TFC) ranged from 19 to 61 ml (mean was 34.3 ml).

Conclusion
Electrical cardiometry is a safe and convenient way of neonatal hemodynamic monitoring. Our data suggests the possible benefit of using EC continuously in monitoring the trend of hemodynamic parameters rather than comparing its measurements to Echocardiography. Further studies in larger number of patients are recommended.
Effect of Timing of Insulin Degludec in Relation to Age in Type One Diabetic children and Adolescents (Single Center Study)
Authors: Mohamed Asmaa Abdallah , Sherif Eman Mounir , Aly Hanan Hassan , Fereig Yasmeen Abd Elaziz 
Published: November 2024

Abstract

Background
Glycemic control needs optimal adjustment of basal insulin timing for better health in children with diabetes, optimal adjustment of basal insulin to overcome hypoglycemia and glycemic variability (GV) depend on its duration of action and peakless profile.

Aim of the Work
This study aims to identify the best timing of long-acting basal insulin (degludec) in children with type 1 diabetes mellitus.

Patients and Methods
The current study is an observational study studying glycemic control as evidenced by HbA1c % in relation to the time of long-acting insulin (degludec) The study included 20 patients (age between 4:18 years), with type 1 diabetes received morning dose of insulin degludec then same dose but at night. participants are regularly following up at the Pediatrics and Adolescents Diabetes Unit (PADU), children’s Hospital, Ain Shams University in the period between October 2022 and April 2023, detailed history from participants was taken including: age, history of onset and duration of DM, associated co- morbidities, family history, Insulin regimen including mode of insulin delivery, total daily insulin dose (unit per Kg per day), type of insulin, frequency of injection and current injection timing, Thorough clinical examination: anthropometric parameters were assessed on WHO Z score and clinical evaluation of injection sites for apparent lipodystrophy. Investigations included the annual follow up investigations of the patient (CBC, lipid profile, thyroid profile, liver function tests, urinary albumin creatinine ratio, celiac screening, last hemoglobin A1c) and fundus examination. Glycemic control was assessed by pre-prandial and post-prandial readings and Hb A1c.

Results
The current study compares participants on morning regimen degludec followed by same dose at night regarding the impact on glycemic control, showed that Hb A1c % was better in children and adolescents using insulin degludec in the morning (mean of Hb A1c (8.23 ± 0.45%) compared to when using insulin degludec at night (mean of Hb A1c 9.16 ± 2.50%), irrespective of age.

Conclusion
Hb A1c as a measure of glycemic control was better when insulin Degludec was used in a morning regimen than when insulin degludec was given at night. Larger studies are needed to support this and recommend the best timing for insulin degludec in Pediatric age group.
Natural Anticoagulants in Transfusion Dependent Beta-Thalassemia Patients
Authors: Yousef Aya Ahmad Mohamed , Sayed Safa Matbouly , Nagy El-Khazragy Nashwa , Mohsen El Laboudy Mohamed Abdel 
Published: November 2024

Abstract

Background
Thromboembolic events have been recorded in Beta-Thalassemia Patients. Several etiologic factors may play a role in the pathogenesis of the hypercoagulable state in thalassemia among which is decreased levels of naturally occurring anticoagulants such as protein C, protein S and anti-thrombin III.

Objective
To evaluate levels of naturally occurring anticoagulants in transfusion dependent beta-thalassemia patients and to assess the relationship between natural anticoagulants levels and the risk for thromboembolic complications among these patients.

Patients and Methods
This case control study included 40 transfusion dependent beta-thalassemia patients and 40 healthy participants as controls. Patients were recruited and assessed for eligibility from Ain Shams University Haematology unit. Protein C%, anti-thrombin-III (AT III) % and protein S% levels were measured and their correlations to liver enzymes were evaluated.

Results
The mean level of protein C (77.0%), protein S (79.50%) and AT III (90.0%) were significantly reduced in patients' group in comparison with control subjects (p-value &lt;0.001). These findings were significantly positively corelated withthrombotic events, age, transfusion index, platelets count, serum ferritin, and aspartate transaminase (p &lt; 0.05). Type of the chelation therapy, splenectomy, T2 star liver, T2 star heart, serum creatinine and albumin did not affect significantly the serum levels of the studied natural anticoagulants (p &gt; 0.05).

Conclusion
Natural anticoagulants namely protein C, protein S and anti-thrombin III were significantly reduced among transfusion dependent beta-thalassemic patients which seem to contribute to the increased risk of thromboembolic events in these patients. This study supports the use of early prophylactic anti-coagulant therapy for this high-risk group.
Total Body Fat Mass in Relation to Insulin Resistance in Type 1 Diabetic Patients
Authors: Elhabashy Safinaz Adel , Salah Nouran Yousef , Hilal Basma Abd El-Nasser , Kamal Christein Monir 
Published: November 2024

Abstract

Background
The introduction of intensive insulin therapy improved glycemic control among people with type 1 diabetes (T1DM). However, an increased prevalence of obesity occurred in those with T1DM with increased insulin resistance.

Aim
to determine the relationship between total body fat with each of glycemic control and insulin resistance among children with T1DM.

Methodology
Hundred twenty children with T1DM aged 10-18 years were recruited from the Pediatric and Adolescent Diabetes Unit (PADU), Ain Shams University. They were assessed for insulin requirements, fasting lipids profile, glycated hemoglobin (HbA1c%) and bio- impedence to assess total fat mass with calculation of the estimated glucose disposal rate (eGDR) for insulin resistance.

Results
The body mass index Z score of the studied children with T1DM was 0.6 (0 – 1.2) and their mean HbA1c% was 9.14±1.99%. Children with T1DM having insulin resistance had significantly higher BMI z score, insulin dose, LDL level and total body fat than those without (p = 0.024, p = 0.005, P = 0.009 and p = 0.007, respectively). Total body fat was significantly correlated with duration of diabetes (p &lt; 0.001), BMI z score (p &lt; 0.001) and eGDR (p = 0/009) among the studied children with T1DM. eGDR significantly correlated with both total and visceral fat (P = 0.009 and P = 0.007 respectively) in the studied children and adolescents with T1DM.

Conclusion
T1DM children having insulin resistance had significantly higher total body fat than those without insulin resistance.
Cardiorespiratory Assessment of Preterm and Near Term Neonates on Nasal Continuous Positive Airway Pressure (CPAP) in Different Body Positions
Authors: Hassan Maha Hassan Mohammed , El-sakka Abeer Salah Eldin , Ahmed Doaa abdel-Hamid Mohammed , Alhassanin Arwa Hamdy Al sharabasy 
Published: November 2024

Abstract

Background
The use of continuous positive airway pressure (CPAP) is one of the recommended interventions to reduce morbidity and mortality in preterm infants. The effect of body position is directly associated with clinical conditions and factors related to respiratory assistance.

Aim and Objectives
To evaluate the effect of different body positions on different cardiac, respiratory parameters for preterm and near term neonates with respiratory distress treated with CPAP.

Patients and Methods
This one arm clinical observational study was conducted on 81 preterm and near term neonates who had respiratory distress, placed on nasal CPAP. They were placed in prone, supine, left lateral and right lateral position, each for 90 minutes. The neonate was kept in each position for 30 minutes (washout period), then was observed clinically and monitored for respiratory rate, heart rate, oxygen saturation. Also, using electrical cardiometry cardiac output, stroke volume and index of contractility (ICON) level were monitored for 60 minutes, recorded at intervals of 10 minutes then the average was taken.

Results
Respiratory rate was significantly decreased (p-value &lt; 0.001) in prone position 42.65 ±5.03(breath/min), compared to 45.41±7.73(breath/min)in supine position, 45.2±5.39(breath/min) in left lateral position, 45.23±5.32(breath/min) in right lateral position. Oxygen saturation was significantly increased (p-value &lt;0.001) in prone position 97.3%±1.6% compared to 95.8±1.5% in supine position, 94.9%±1.6% in left lateral position, 95±1.5% in right lateral position, while there was no statistically significant difference as regard heart rate (p-value 0.64). As regards cardiometry parameters, cardiac output and stroke volume were highly significantly increased(p- value 0.019, &lt;0.001 respectively) in prone position; that cardiac output was 0.41 ± 0.13 (l/min) in prone position versus0.38± 0.14 (l/min) in supine and right lateral positions, 38± 0.13 (l/min) in left lateral position, stroke volume was 3.02 ± 1.03(ml) in prone position versus 2.67 ± 0.87(ml) in supine position, 2.72 ± 0.94 (ml) in left lateral position, 2.74 ± 1.07(ml) in right lateral position.

Conclusion
Neonates on nasal CPAP in prone position had the highest oxygen saturation, lowest respiratory rate, highest stroke volume and cardiac output, further researches are needed on a greater scale.