bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study between Quartz Laser Ablation of Prostate (QLAP) and Transurethral Resection of Prostate (TURP)
Authors: Shaker Hassan S , Saafan Ahmed , Khedr Ashraf , Attia Hatem Soltan 
Published: November 2024

Abstract

Background & Purpose
Pulsed beams produced by laser at wavelength of 2140nm which have above 60% absorption by water that result in vapor bubble which has a destructive effect on tissues and atones (jack hummer effect) but with limited coagulation make it suitable for small sized prostate below 60gm and/or bladder neck incision--. This study was conducted to compare the safety and efficacy of transurethral resection of prostate (TURP) versus Quartz Laser Ablation of prostate (QLAP) regarding patient outcome and intraoperative complications.

Study Design
Prospective, case controlled comparative study.

Setting
Ain Shams, Shaker and Maadi military hospitals.

Subjects
We included 100 patients with lower urinary tract symptoms (LUTS) symptoms secondary to benign prostate enlargement (BPE), and classified them two groups: 50 patients treated by monopolar Transurethral Resection of Prostate (TURP) (Group A), and 50 patients treated by Quartz Laser Ablation of Prostate (QLAP) (Group B).

Methods
All patients were subjected to full history taking, examination, Preoperative laboratory investigations including, Hemoglobin, hematocrit, serum Na and K and serum PSA. Perioperative radiological investigations including, abdominopelvic ultrasound with pre and post void residual urine, transrectal ultrasound to estimate the prostate size and uroflowmetry. Follow up 6 months post operative for any complication, change in IPSS score, serum PSA, urine analysis, post voiding residual and uroflowmetry were evaluated.

Results
In the studied population, the average age was (68.03 ± 8.2) years. Comparative study between two groups revealed non- significant difference among post-operative urological data. However, there is a significant difference in median value of PVR but not in median difference value. Similarly, there is no statistically significant difference as regard to laboratory findings with an exception to potassium level. Regarding post-operative complications; the early complications rate was (28%), and the late complications rate was (25%). Comparative study between the 2 groups revealed non-significant difference as regards post-operative complications (p &gt; 0.05).

Conclusion
To conclude, QLAP technique for management of BPH was proven to be effective in decreasing post-operative PSA, prostate size, IPSS total, and PVR. But, both QLAP and Monopolar TURP techniques had the comparable safety and complications rates.
Efficacy of Holmium Laser Urethrotomy vs in Combination with Intralesional Paclitaxel Injection in the Treatment of Urethral Stricture
Authors: El-Ansary Mahmoud Mohamed Magdy , Safaan Ahmed Mohamed , Mousa Waleed Elsayed , Samir Younan Ramsis 
Published: November 2024

Abstract

Background
Male Urethral strictures are one of the most common reasons for urological admissions. They are associated with urinary tract infections, bladder stones, fistulas, sepsis and possibly renal insufficiency. Minimally invasive surgical approaches are utilized efficiently and safely in the treatment of urethral strictures.

Aim of the Work
To evaluate the outcome of visual internal urethrotomy with a holmium: yttrium- aluminum- garnet laser Vs in combination with intralesional paclitaxel injection.

Patients and Methods
A prospective interventional study that was conducted at Ain Shams University hospitals on 60 patients attending Ain Shams University hospitals Urology clinic for 6 months. Patients were randomly allocated by closed envelop method into either Group A or Group B in a 1: 1 ratio. Group A consists of those who underwent laser internal urethrotomy only, and Group B of those who underwent laser internal urethrotomy with circumferential submucosal paclitaxel injection at the stricture site.

Results
There was statistically significant improvement in IPSS score at 3 months in group B compared to group A with P-value 0.034. There was statistically significant improvement in Q- average at 3 months in group B compared to group A with P-value 0.014. Q-max was slightly improved in group B compared to Group A at 3 months yet there was no statistically significant difference with P-value 0.545. Overall recurrence was less frequent in group B (24.1%) compared to group A (39.3%) with no statistically significant difference with P-value 0.219.

Conclusion
The addition of intralesional paclitaxel injection to the treatment regimen may enhance the outcomes of visual internal urethrotomy for urethral strictures, leading to improved symptom relief and reduced recurrence rates, particularly in the midterm follow-up period. Further research may be warranted to validate these promising results and explore the long-term effects of this combined approach.
Impact of Ureteral Access Sheath during Flexible Ureteroscopy as Regard Complication and Stone Free Rate
Authors: Mourad Mohamed Sherif , Tawfeek Ahmed Mohamed , Osman Mohamed Mostafa Elsayed 
Published: November 2024

Abstract

Background
Ureteral access sheath use has been widely accepted by urologists since older ureteroscopes were difficult to insert into the ureter due to their stiffness, width and limited deflection angles. However, with advancing technology and design improvement, new generation ureteroscopes are thinner and built with lighter and more flexible materials than their older counterparts. This in turn has produced devices that are easier to maneuver, meaning that procedures can be performed without needing UAS thus the actual benefit of UAS was under question.

Objective
To compare the usage of UAS versus not using the UAS during FURS regard operative time, intra operative, postoperative complications and patient satisfaction.

Patients and Methods
120 patients with symptomatic upper ureteric and renal pelvic stone disease were enrolled, they were divided into 2 equal groups one underwent FURS with UAS and the second group underwent FURS without UAS.

Results
There was a statistically significant higher frequency of postoperative complications in No UAS comparing to UAS group with p-value (p &lt; 0.05) in the form of Postoperative fever and Postoperative sepsis. While, there is no statistically significant difference between groups according to OR time (min.), Stone free rate, Hospital stay (hrs.) and Postoperative pain.

Conclusion
In the current study we aimed to compare the usage of UAS versus not using the UAS during FURS regard operative time, intra operative, postoperative complications and patient satisfaction. In the included patients, There was a statistically significant higher frequency of postoperative sepsis and fever in No UAS comparing to UAS group, with p-value (p &lt; 0.05). While, there is no statistically significant difference between groups according to operative time “min”, Stone free rate, Hospital stay (hrs.) and Postoperative pain. Moreover, significant association of postoperative sepsis and fever with residual stones in included patients. UAS has superior advantage over no-UAS due to lower incidence of sepsis and fever in the current study.
Double Dose versus Standard Dose of Tamsulosin with Solifenacin for Treatment of Ureteric SRS (Stent Related Symptoms)
Authors: Osman Tarek , Saied Mohamed , Ramadan Mohamed Ramadan Mohamed 
Published: November 2024

Abstract

Background
Ureteral stents provide drainage of the upper urinary tract, when obstruction of the ureter is present or anticipated. Indicated in relieving urinary obstruction, following or prior to ureterorenoscopy, Prophylactic before ESWL, Conservative Treatment of Upper Urinary Tract Trauma to reduces urinary leakage and the risk of strictures, Reconstructive Surgery of the Upper Urinary Tract and identifying the ureter before specific abdominal surgeries. Stent-related symptoms have a high prevalence. They include irritative voiding symptoms including frequency, urgency, dysuria, incomplete emptying; flank and suprapubic pain; incontinence, and hematuria.

Objective
To evaluate the effectiveness of Double dose versus standard dose of tamsulosin with solifenacin in relieving stent related symptoms.

Patients and Methods
A Randomized controlled clinical trial was conducted on 64 Egyptian patients from the outpatient clinic and inpatients Urology department of Ain Shams University Hospital for Six months.

Results
After 2 weeks of medication, the double dose of tamsulosin with solifenacin was more effective for stent-related symptoms than standard dose. There was significant difference in the score between the double dose and the standard dose. Side effects were more frequent among the double dose group with significant difference only in retrograde ejaculation and dry mouth.

Conclusion
Combination therapy of Tamsulosin with solifenacin is effective in relieving stent related symptoms. In some patients who are still complaining even with this combination we can double the dose of tamsulosin and solifinacin in order to relieve the symptoms even if the temporary and accepted side effects will increase.
Healing Evaluation of Varicose Leg Ulcers after Injection Sclerotherapy of Pathological Leg Perforator Veins
Authors: Ateya Beshoy Magdy Alshahat , Mahmoud Abdelbary Mostafa Soliman , Wahba Ramez Mounir , Mahmoud Amr Abdelghaffar , Mohamed El-Awady Karim Shalaby 
Published: November 2024

Abstract

Background
Scottish Guideline defined the chronic venous leg ulcer “as an open lesion between the knee and the ankle joint that remains unhealed for at least four weeks and occurs in the presence of venous disease”. Venous Leg Ulcers (VLUs) account for 70% of all leg ulcers and estimates 1% of the population with a prevalence that increases with age according Edinburgh study, which was a cross-sectional study of a random sample.

Aim of the Work
To evaluate the efficacy of injection sclerotherapy of incompetent perforators in the healing of venous leg ulcers.

Patients and Methods
This study was conducted on 50 patients with chronic venous leg ulcers that had been presented for at least four weeks ago. To evaluate the clinical efficacy of Duplex-guided foam sclerotherapy with compression therapy in comparison with compression therapy alone, we divided the patients with randomization into two groups. Group A was conservatively managed by four-layer compression bandage and Group B was managed by application of duplex guided injection sclerotherapy and four-layer compression bandage.

Results
In our study, there is statistically significant positive correlation between duration of ulcer, ulcer surface area and duration to complete healing. On linear regression analysis of factors significantly correlated with duration of complete healing, only ulcer surface area at start of treatment was significantly associated with it (β = 1.031, p &lt; 0.001). Increased ulcer surface area at start of treatment by 1 cm2 increases duration of healing by about 1 week.

Conclusion
Duplex-guided sclerotherapy is a simple procedure, no hospitalization, no anaesthesia, can be done in outpatient clinic and the patient can return home after 45 min and no work off period. The relative healing period and its evident success, make this the first line treatment for venous ulcer and superior to compression alone.
Predictors and Risk Factors of Wound Complications in Diabetic Patients Post Lower Limb Amputation: A Prospective Study
Authors: Abouzeid Mohamed Mahmoud , Wahba Ramez Mounir , Abdulmonem Ayman Hossameldin , Adly Nahla Nader , Abdullah Mohamed Hosny Ibrahim Mohamed 
Published: November 2024

Abstract

Background
Despite advances in limb-salvage surgery, lower extremity amputation is still commonly required as an end result of the progression of arterial occlusive disease or failed arterial reconstruction. Furthermore, the increasing prevalence of diabetes has led to the appearance of more patients with foot complications leading to eventual lower extremity amputation.

Objective
To investigate the predictors and risk factors associated with wound complications after lower limb amputations in diabetic patients.

Methods
This is a prospective study, in which we follow up diabetic patients who went for lower limb amputation (AKA or BKA) and record the incidence of post operative wound complications. The study included 30 diabetic patients undergoing lower limb amputation in Ain Shams University hospitals, with postoperative follow up for 24 weeks, and the outcome measured is the incidence of post operative complication in relation to preoperative risk factors and predictors.

Results
Regarding the comparison between AKA and BKA it was found that patients who had BKA had higher rates of superficial SSI which were statistically significant (P &lt; 0.05). While patients who had AKA had higher rates of pneumonia and mortality but not statistically significant (P &gt; 0.05). Wound disruption, pulmonary embolism and MI were higher in patients who had BKA but was not statistically significant (P &gt; 0.05). Regarding assessing predictors and risk factors for assessing post operative complications it was found that female gender, smoking and obesity (BMI &gt;30) was statistically significant in assessing the risk factors (P value &lt;0.05). Also regarding other predictors and risk factors of postoperative complication after the end of the study duration it was found that lower HGb levels (Anemia), Hct, ESR and CRP are considered predicators (P-value &lt; 0.05). Other factors such as preoperative sepsis, emergency status and presence of infection were strongly related to post operative complication P-value 0.003 each (P-value &lt; 0.05).

Conclusion
Surgical site infections (SSIs) following lower extremity amputations (LEAs) are a major cause of patient morbidity and mortality. The objectives of this study were to investigate the incidence of SSI and other wound complications after LEA in diabetic patients and to assess risk factors associated with SSI. This study found that below-the-knee amputation, smoking, obesity, emergency status, anemia, lower hematocrit and preoperative sepsis to be associated with SSIs.
Evaluation of the Role of MicroRNA-663a in Pediatric Lupus Nephritis
Authors: abdelaziz albostany Toulin , Tarek Marwa , Adel Sherihan , Imam Maha , El- Owaidy Rasha , Ahmed Manal Basyouni 
Published: November 2024

Abstract

Background and Aim
Lupus Nephritis (LN) is a serious manifestation of systemic lupus erythematous (SLE) with poor prognosis for pediatric patients resulting in high morbidity and mortality rates. MicroRNAs (miRNAs) are short, non-coding RNAs that serve as epigenetic modulators, affecting gene expression and influencing our understanding of disease causes and pathology. Thus, we sought to explore urinary expression of miR-663a in LN among SLE children.

Patients and Methods
The urinary miR-663a expression levels were estimated in cellular pellets from 15 biopsy-proven active LN patients and 15 healthy controls.

Results
LN patients had significantly higher urinary miR-663a expression levels compared to control group (p &lt; 0.0001).

Conclusion
miR-663a could provide a specific noninvasive diagnostic and follow-up tool for LN patients.
Role of Two Dimensional Left and Right Ventricular Speckle Tracking Echocardiography in Early Detection of Chemotherapy Induced Ventricular Systolic Dysfunction
Authors: Fawzy Ahmed A , El-Menyawi Khaled A , Sallam Walid M , Zahran Mohamed E 
Published: November 2024

Abstract

Background
Cancer and cardiovascular diseases are the main causes of mortality worldwide. Although the incidence of cancer is rising, modern comprehensive management including surgery, chemotherapy and radiotherapy led to decreased mortality and prolonged survival, but also a large spectrum of cardiovascular complications. Since mortality from patients who develop heart failure secondary to chemotherapy is as high as 60% by 2 years. Early detection of subclinical Cancer Therapeutic Related Cardiac Dysfunction (CTRCD) is of utmost importance, conventional EF measurement fails to detect subtle changes in LV function, so a more sensitive tool is needed.

Objective
To detect early subclinical left & right ventricular dysfunction based on measurement of 2D LV & RV speckle tracking derived strain values.

Patients and Methods
The current study is a prospective study which included 101 asymptomatic female patients with newly diagnosed breast cancer who received anthracycline ± trastuzumab based chemotherapy regimen. A comprehensive echocardiographic examination was performed to all patients prior to receiving the chemotherapy (T0), at 3 months (T1) and at 6 months after (T2). All patients had pre- treatment normal LV EF. We aimed at studying the changes in LV & RV mechanics and detecting whether they can help in early prediction of cardiotoxicity. Cardiotoxicity was defined decrease in EF &gt; 10% from baseline value to EF &lt; 55% in asymptomatic patients or &gt; 5% in symptomatic patients “as defined by the cardiac review and evaluation committee (CREC)”.

Results
The mean age of the study population was 48.75±10.07 years. CTRCD occurred in 24 patients (25.5%) with mean EF by Simpson`s method 59.29±3.50 % at (T0), 49.54±5.63% at (T1), 45.79±4.49% at (T2). While in non-CTRCD patients the mean EF was 60.21±2.80% at (T0), 59.13±2.53% at (T1), 58.29±2.63% at (T2). RV systolic function impairment (S`&lt;10 cm/s) was more prevalent occurring in 37 patients representing 39.4% of the study population. By univariate and multivariate regression analysis LV GLS at (T1) (cut-off value &lt;-15% with relative 12.5% reduction from the baseline value) was a strong predictor of CTRCD, but combining LV GLS with RV GLS & RV FWLS was the strongest (AUC=0.947, sensitivity=91.67%, specificity=90%).

Conclusion
Anthracycline ± Trastuzumab treatment leads to changes in LV & RV mechanics with more prevalent deterioration in RV values. Presence of lower LV & RV strain values at the base line together with reduction of these values after chemotherapy treatment both can predict later development of CTRCD. Combining LV GLS with RV GLS & FWLS values at (T1) is the strongest predictor of subsequent CTRCD.
Prevalence and Predictors of Trans Radial Approach Complications in Coronary Angiography and Percutaneous Coronary Intervention
Authors: Korraa Ahmed , Gamal Adel , Badran Haytham , Moussa Mohammed 
Published: November 2024

Abstract

Background
An increasingly popular approach for both diagnostic and interventional coronary procedures is the transradial approach (TRA). When compared to a transfemoral approach (TFA), (TRA)was found to lessen vascular complications. The most frequent and commonly silent transradial approach (TRA) complication is radial artery occlusion (RAO), which is followed by less serious vascular complications including hematoma and radial artery spasm.

Aim and Objectives
Evaluate the prevalence and predictors of complications of transradial approach (TRA) immediately after TR procedure and follow-up by radial artery doppler ultrasonography within 24 hours.

Subjects and Methods
This prospective registry observational study involved 250 patients who underwent either diagnostic coronary angiography, elective PCI, or primary PCI by TRA. It was carried out at Ain Shams University Hospitals and October 6 University Hospital.

Result
RAO, affected 20% of patients who underwent a TR procedure, which was the most frequent complication, followed by hematomas and spasms, each affected 8% of patients. It is noteworthy that none of the patients experienced hemorrhage, pseudoaneurysms, or AV fistula. Univariate and multivariate regression analysis revealed that, factors independently associated with TRA complications were patients in the age group (≥ 60 years old) (OR = 19.33, 95%CI: 9.09 to 41.11, P &lt; 0.001) and female patients (OR = 2.67, 95%CI: 1.56 to 4.55, P &lt; 0.001), and according to the periprocedural factors to be wrap closure by rolled gauze (OR = 15.17, 95%CI: 8.03 to 28.65, P &lt; 0.001) and delayed time of compression release (OR = 2.97, 95%CI: 2.07 to 4.26, P &lt; 0.001).

Conclusion
Older patients, female patients, lower BMI, longer procedure duration, more number of catheters used, wrap closure with rolled gauze, and delayed time of compression were the predictors of transradial approach (TRA) complications immediately following TR procedure and in the follow-up by radial artery Doppler ultrasonography within 24 hours. RAO, which affected 20% of patients who underwent a TR procedure, was the most frequent complication, followed by hematomas and spasms, each affected 8% of patients. It is noteworthy that none of the patients experienced hemorrhage, pseudoaneurysms, or AV fistula.
Evaluation of Right Atrial Function by 2D Speckle Tracking Echocardiography in Patients Undergoing Primary Percutaneous Coronary Intervention after Inferior ST Segment Elevation Myocardial Infarction
Authors: Mamdouh Mikhail , Karim Khalid , Missiri Ahmed El , Onsy Ahmed 
Published: November 2024

Abstract

Aim and Objectives
The aim of the study is to evaluate right atrial function by 2D speckle tracking echocardiography in patients undergoing primary percutaneous coronary intervention after inferior ST segment elevation myocardial infarction.

Patients and Methods
This study included 100 patients diagnosed with Inferior STEMI subdivided into patients with RV infarction (26 patients) and those without RV Infarction (74 patients) in the ER fulfilling the inclusion criteria compared to the Control Group (50 patients) of healthy individuals matched in the same age group with no history of acute coronary syndrome and no cardiovascular risk factors, these patients were assessed demographic data, risk factors, general examination, local examination, laboratory measure, ECG and full echocardiographic assessment including 2DSTE evaluation of the RA.

Results
In our study the results showed that RA strain during reservoir phase (RASr) and RA strain during conduit phase (RAScd) were reduced among the patients with inferior wall MI compared to the control group (P-value: &lt;0.001), While RA strain during contractile phase (RASct) was preserved among the patients group (P-value: &lt;0.001), Also RA total emptying fraction (RA EF) and RA total emptying volume (RA EV) were preserved among the patients group compared to the control group (P-value: 0.095, 0.062 respectively). Then we compared the patients with inferior wall myocardial infarction with RV infarction to the patients with no RV infarction, The results showed that RA strain during reservoir, conduit and contractile phases were preserved among the patients with RV infarction compared to those without RV infarction (P-value: 0.196, 0.118, 0.266 respectively), While RA EF and RA EV were significantly reduced among the patients with RV infarction compared to those without RV infarction (P-value: 0.029, 0.038 respectively), There was a positive correlation between RA EF with RV functions parameters as TAPSE (r: 0.377, P-value: &lt;0.001), FAC (r: 0.425, P-value: &lt;0.001), Also There was a positive correlation between RA EV with RV functions parameters as TAPSE (r: 0.239, P-value: 0.017), FAC (r: 0.378 P-value: &lt;0.001)

Conclusion
RA strain during reservoir phase (RASr) and RA strain during conduit phase (RAScd) were significantly lower in patients with inferior wall myocardial infarction compared to the control group, while RA strain during contractile phase (RASct),RA Emptying Fraction (RA EF) and RA Emptying Volume were preserved among the patients with inferior wall myorcardial infarction compared to control group. Patients with inferior wall myocardial infarction with RV infarction have lower RA emptying fraction (RA EF) and RA emptying volume than those without RV infarction.