bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long Term Effect of Gamma Knife Radiosurgery versus Surgical Excision on Pituitary Hormones in Patients with Non-Compressive Non-Functioning Pituitary Macro Adenomas: A Systematic Review
Authors: Samir Mohammed Wael , Elsayed Ahmed Mohammed , Abdel-Latif Assem Mounir M , Abd Elmonem Elngar Mahmoud Mohammed 
Published: November 2024

Abstract

Background
Pituitary adenomas (PAs) are the second most common brain tumors comprise around 10%– 25% of all intracranial tumors of all primary brain tumors. Their clinical classification is defined on the basis of hormonal level into; Non-Functioning adenomas (68.8%) and Functioning ones (31.2%).

Aim of the Work
Aim of the work is to compare the surgical approach vs gamma knife radiosurgery for treatment of non-functioning pituitary macro adenomas in all age groups. We highlight the feasibility of each treatment modality and evaluate its advantages and limitations regarding hormonal outcomes.

Patients and Methods
We searched PubMed, Google scholar search engine, Cochrane database of systematic reviews, EMBASE and science Direct, using the following keywords “Pituitary adenoma/tumor, endoscopy or endoscopic, non-functioning pituitary adenoma, skull base surgery, gamma knife, stereotactic radiosurgery, hormonal effect ”. The mentioned databases were searched for studies published during period from 1 January 2000 to 1 September 2023.

Results
The total number of patients in included studies was 1237 patients. The mean age of patients was 56.55 years (range 54.2 - 59 years). The mean follow up duration of the included studies was 10.94 months (range 6 - 12.7) months. The mean tumor size was 29.03 mm (range 24.8 - 36.3) mm. All the surgical studies patients were treated using endoscopic trans sphenoidal approach. Basic study details and patient characteristics treated with Gamma Knife Radiosurgery (GKR). Again, all the included studies were retrospective in nature. The total number of patients treated in the GKR studies were 243 patients. Across all studies, 51.85% of patients were men, and the median age was 59.75 years (range: 50–69)

Conclusion
Endoscopic trans sphenoidal surgery and gamma knife radiosurgery are valid options as a treatment of non-functioning pituitary macro adenoma, however endoscopic transsphenoidal surgery offer better hormonal outcomes and less adverse effects when compared to gamma knife radiosurgery.
Comparison between Different Temporary Measures for Management of Post- Hemorrhagic Hydrocephalus in Premature Infants: A Systematic Review
Authors: Hammad Omar Youssef , Nosseir Mohamed Elsayed Ali , Abdelnaiem Ismaiel Ibrahim Abdelmohsen , Ghaly Saif Michael Adel 
Published: November 2024

Abstract

Background
Germinal matrix hemorrhage and subsequent posthemorrhagic hydrocephalus are common among pre-term infants due to multiple factors including fragility of germinal matrix vasculature, swinging increases of arterial and venous pressure, periodic hypoxia, and high metabolic demand.

Aim of the Work
To compare between Ventricular access device (VAD) and Neuroendoscopic lavage (NEL) as temporary measures for management of posthemorrhagic hydrocephalus in premature infants in terms of incidence of permanent shunt placement, and post operative complications like infection. This will be done through a systematic review of literatures addressing this research question.

Patients and Methods
Our study included 13 observational studies (12 retrospective and 1 prospective) comparing ventricular access device insertion vs neuroendoscopic lavage in management of posthemorrhagic hydrocephalus in pre-term infants regarding the need for VP shunt insertion and post operative complications mainly post operative infection and malfunction of the temporary CSF diversion, most of the cases had germinal matrix hemorrhage G III-IV according to papille classification, the results showed that while the neuroendoscopic lavage group had lower rate of VP shunt insertion, they had higher rate of post operative complications mainly malfunction of CSF diversion (The incidence of post operative infection was similar in both groups).

Results
In this review while comparing the need for VP shunt insertion in both groups was somewhat simple, comparing complications on the other hand was problematic due to the heterogenicity between types of complications and the underlying comorbidities, with different follow up periods and most of the complications is not shared by both groups.

Conclusion
Based on our systematic review and other available data in the literature, the neuroendoscopic lavage may be the preferred intervention for management of posthemorrhagic hydrocephalus in preterm infants regarding the incidence of permanent VP shunt insertion, although it has higher rate of malfunction and no statistical difference in post operative infection compared with the ventricular access device group.
Growth Hormone Pretreatment in Poseidon Type IV Undergoing ICSI Using Minimal Induction Protocol: A Randomized Controlled Trial
Authors: Ibrahim Khaled , Fouad Mustafa , Mohamed ElTaieb Ebtihal , ElSaed Ahmed M 
Published: November 2024

Abstract
The aim of this of this clinical trial is to explore whether growth hormone (GH) pretreatment is beneficial for patients with poor ovarian reserve undertaking invitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment. Poor ovarian reserve patients with anti-Mullerian hormone (AMH) &lt;1.2 ng/mL were recruited and divided into the GH adjuvant group (GH+ group) and the counterpart without GH pretreatment (GH- group). One-to-one case-control matching was performed to adjust essential confounding factors between the GH+ group and GH- group. A total of 132 patients were included in the present study with 66 patients in each group. minimal ovarian stimulation protocols were applied for ART treatment. Patients were recruited according to POSEIDON group 4 (PG4, age ≥35 years). The demographic data, cycle characteristics, and clinical outcomes between the GH+ group and GH- group, as well as in the further stratified analysis of PG4 were compared. GH adjuvant showed no significant effect on the ovarian response and live birth rate in poor ovarian reserve patients. GH adjuvant failed to promote the live birth rate in PG4. In conclusion, GH pretreatment has no significant difference as an adjuvant in POSEIDON poor ovarian reserve patients older than 35.
Diagnostic Correlation between Saline Infused Sono Hysterography and Three-Dimensional Transvaginal Ultrasound in the Assessment of Cesarean Section Scar Defect. A Study of a Diagnostic Test Accuracy
Authors: Ahmed Mortada El Sayed , Kolaib Magdy Hassan , Anwar Rania Gamal , Sherif Israa Bahaa Hassan , Maaty Aliaa Mohamed 
Published: November 2024

Abstract

Background
The evolution of Sono hysterography over the past years has contributed significantly to the assessment of uterine cavity. Saline infused Sono hysterography (SIS) may be recommended as an alternative to Diagnostic Hysteroscopy for the assessment of the uterine cavity and uterine scar in women with previous Cesarean Section. Three-dimensional (3D) ultrasonography that enhances visualization of the lower uterine segment (LUS), myometrial thickness and the size of uterine diverticulum is a more recent tool used to diagnose post- cesarean section uterine diverticulum.

Objective
To compare accuracy of three-dimensional transvaginal ultrasound versus saline infused sonography for assessing the characteristics, frequency of caesarean scar defects in symptomatic patients with a history of cesarean section.

Patients and Methods
This study was conducted with 72 women. patients were recruited from the ultrasound unit underwent both three-dimensional transvaginal ultrasound and saline infused son hysterography. This study, conforming to the declaration of Helsinki, was approved by the ethical committee of Obstetrics and Gynecology department, Ain Shams University, ethical committee number FMASU M D 52 \2021.

Results
3D transvaginal ultrasound and Sono hysterography showed almost good agreement regarding prevalence of niche with kappa (κ) 0.780 with p-value (p &lt; 0.001). Both imaging modalities show statistically significant higher mean value of volume in SIS was 591.67±271.05 comparing to 3D TVUS was 444.36±219.42, with p-value (p = 0.004).

Conclusion
There is a substantial agreement between 3D TVUS and SIS in evaluating various niche characteristics, encompassing depth, length, width, volume, AMT and RMT. The data strongly supports the advantages of 3D TVUS over SIS for assessing Cesarean scar defects, commonly known as “Niche.” These benefits encompass cost-effectiveness, improved time efficiency, enhanced patient tolerability, and heightened patient satisfaction associated with the 3D TVUS procedure.
Intraperitoneal Gas Drain to Reduce Postsurgical Shoulder Tip Pain in Gynecological Laparoscopy
Authors: Mahmoud Mohamed Taha Ismail , Abdel-Hafeez Mohamed Abdel Hameed , Zaki Radwa Mansour Mahamed , Saady Abdelghafour Kholoud Khaled 
Published: November 2024

Abstract

Background
Operative gynecologic laparoscopy has become the preferred method for treating benign gynecologic diseases due to its minimally invasive nature and faster recovery compared to laparotomy. However, post-laparoscopic shoulder pain (PLSP) is a common complaint following laparoscopic surgeries, affecting patients' satisfaction and recovery. Various methods have been proposed to alleviate PLSP, but consensus on their effectiveness remains elusive.

Aim of the Work
This randomized controlled clinical trial aims to investigate the effect of gas drainage by intraperitoneal drain on shoulder pain in women after laparoscopic surgery in comparison to no drain use.

Patients and Methods
A randomized controlled clinical trial involving 120 female patients undergoing laparoscopic surgery was conducted to investigate the effect of intraperitoneal drainage on postoperative shoulder pain. The patients were divided into two groups: the study group (n = 60) with intraperitoneal drain placement, and the control group (n = 60) with routine technique and no drain use. Visual Analog Scale (VAS) scores were used to assess shoulder and abdominal pain at different postoperative time points.

Results
The study demonstrated that intraperitoneal drainage significantly reduced postoperative shoulder pain in the first 12 hours after surgery compared to the control group (p &lt; 0.001 at 3 and 6 hours, p = 0.038 at 12 hours). However, no significant difference in shoulder pain was observed between the two groups at 24 hours post-surgery (p = 0.451). The need for postoperative analgesia was also lower in the drainage group (p &lt; 0.001). These findings align with previous studies suggesting the efficacy of drainage in reducing shoulder pain after laparoscopic surgery.

Conclusion
This study demonstrates the effectiveness of intraperitoneal drainage in reducing post- laparoscopic shoulder pain during the first 24 hours after surgery, consequently reducing the need for postoperative analgesics. These findings support the outcomes of previous investigations, indicating that drain placement may be a valuable strategy to alleviate postoperative shoulder pain in women undergoing gynecologic laparoscopy.
Lactoferrin with Ferrous Gluconate versus Ferrous Gluconate for Treatment of Iron Deficiency Anaemia during Pregnancy
Authors: Hitler Waleed , Saad Amr , El-sabai Khattab Nahla Fathy Abdel-samea 
Published: November 2024

Abstract

Background
Iron deficiency is the most common single-nutrient deficiency worldwide. According to the US Centers for Disease Control and Prevention (CDC) recommendations, the diagnosis of anemia during pregnancy must be based on hemoglobin (Hb) values lower than 11 mg/dl during the first and the third trimester or lower than 10.5 mg/dl during the second trimester. Ferrous gluconate that has to be administered to patients with iron deficiency anemia in large quantities due to the poor bioavailability of inorganic iron. Moreover, oral administration of ferrous gluconate causes many side effects, including gastrointestinal discomfort, nausea, vomiting, diarrhea and constipation. Lactoferrin is a multifunctional iron-binding protein possessing anti-inflammatory and anti-microbial effects.

Aim of the Study
The study aims to compare between lactoferrin with ferrous gluconate versus ferrous gluconate in treatment of iron deficiency anemia during pregnancy.

Patients and Methods
This was a randomized controlled clinical trial that was conducted in Ain Shams University Maternity Hospital (ASUMH) from March 2023 to November 2023 on 40 pregnant women who had iron deficiency anemia during pregnancy recruited from inpatient/outpatient antenatal clinic of ASUMH.

Results
Group B had a significant increase in hemoglobin, hematocrit and serum ferritin level, group A had significantly more nausea than group B (p = 0.013), while there was no significant difference between the groups in terms of constipation or non-compliance (p &gt; 0.05), there is no significant difference between the groups in terms of age or gestational age.

Conclusion
In our study we compared between lactoferrin with ferrous gluconate versus ferrous gluconate in treatment of iron deficiency anemia during pregnancy. Accordingly, we found that Oral lactoferrin with ferrous gluconate is better tolerated with higher increase in mean hemoglobin and lower side effects (nausea) when compared to oral iron therapy alone.
Optical Coherence Tomography Angiography (OCTA) Study of Microvascular Changes in Systemic Lupus Erythematosus (SLE) Patients with no Clinical Ocular Manifestations
Authors: Aziz George Adel , Ezzat Nashwa , Ebeid Weam , Shabaan Elham , Raslan Osama 
Published: November 2024

Abstract

Purpose
The aim of this study is to evaluate retinal microvasculature using OCTA in patients with SLE without signs of retinopathy according to standard lupus retinopathy classification and correlate abnormal vascular density with disease activity and severity.

Methods
in this Prospective observational non-interventional study, 36 eyes of 18 SLE patients were compared with 36 eyes of normal subjects. The retinal capillary plexuses were examined by OCTA at time of enrollment and every 4 months for a year using Angio-OCT Optovue RTVue XR Avanti system (Optovue Inc., Fairmont, CA) with documentation of Foveal avascular zone (FAZ) area in mm, acircularity index(AI), Retinal vessel density in a 300-μm-wide region around the FAZ (FD-300), Retinal vessel density in superficial and deep retinal layers (foveal, parafoveal and perifoveal areas). The scanning area was captured in 6 × 6-mm sections, automatically centered on the fovea (HD angio retina 6 × 6-mm), also radial peripapillary vessel density (HD angio disc 4.5 × 4.5-mm) (superior, inferior, nasal and temporal) were studied. The disease activity and damage risk were evaluated by the SLEDAI-2 K and SLICC/ACR system and a correlation was done between changes found and disease activity.

Results
No difference was found between SLE patients and the normal in foveal avascular zone (FAZ) area, FAZ perimeter, Acircularity Index (AI)(P &gt; 0.05). No difference was found between SLE patients’ macular thickness in foveal region and parafoveal region and the normal (P &gt; 0.05),while mean perifoveal average macular thickness was significantly lower in SLE patients group (p = 0.025). There was a significant decrease in foveal thickness measurements in SLE patients group during follow up period (p = 0.007). SLE patients had significantly lower superficial vessel densities (SVD) than normal in the parafoveal and perifoveal regions (p = 0.001),(p &lt; 0.001) respectively, and during follow up period significant decrease was observed in SVD values (p = 0.001). Regarding the deep capillary plexus (DCP), There was no significant difference between SLE patients group and the normal (p &gt; 0.05), while during follow up period Significant decrease was observed in deep foveal vessel density in SLE patients group (p = 0.013). There was a significant negative correlation between disease activity (measured by SLEDAI-2K and SLICC/ACR scores) and SVD & foveal deep vessel density.

Conclusions
OCTA permits noninvasive quantitative assessment of retinal vessel density in SLE, allowing early detection of altered retinal circulation. superificial Vessel density and foveal deep vessel density could be included in future assessment of SLE activity and damage scores to early detect any changes for early management and treatment.
Study of Retinal Microvasculature Changes in Patients after Blunt Ocular Trauma by Using Optical Coherence Tomography Angiography
Authors: Gamal El-Din Omar A , El-Maamon Tarek A , Eliwa Tamer F , Fawzy Samah M 
Published: November 2024

Abstract

Purpose
To assess structural and vascular changes of the macula and optic nerve in patients with unilateral blunt trauma in comparison to the contralateral sound eye by using optical coherence tomography angiography (OCTA).

Methods
This prospective study was carried out on 50 traumatized eyes and 50 contralateral sound eyes of patients who were subjected to blunt trauma within 7 days of injury. We evaluated best-corrected visual acuity (BCVA), intraocular pressure (IOP), retinal vessel density (VD) of superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillary (RPC) and the foveal avascular zone (FAZ) by OCTA. We also assessed the structural spectral domain (SD)-OCT parameters including central macular thickness (CMT), ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) thickness.

Results
The BCVA was statistically significantly better in controls (0.16 ± 0.24 LogMAR) than traumatized eyes (0.28 ± 0.31 LogMAR) (p = 0.015). There was no statistically significant difference between the traumatized and control eyes regarding the means of SCP, DCP, outer retinal slab and RPC, FAZ area, CMT, IOP, GCC thickness and RNFL average thickness (p  0.05). In the commottio retinae group, the SCP and outer retinal slab VD were significantly lower in some parafoveal quadrants (p`0.05) than the non-commottio retinae group, while IOP, DCP and RPC vessel density, FAZ area, CMT, GCC and RNFL average thickness didn’t show any statistically significant difference between the two groups (p &gt; 0.05).

Conclusion
Blunt trauma did not induce vascular or structural changes in the macula and optic nerve. Only patients with commottio retinae showed a decrease in vascular densities in some parafoveal areas as compared to those without commottio retinae despite no changes in macular structural anatomy as measured by SD- OCT. This finding suggest that OCTA can detect subtle changes that may influence functional prognosis.
A Systematic Review and Meta Analysis of Endprosthetic Replacement versus Cement Spacer in Reconstruction of Proximal Humerus Following Proximal Humerus Metastasis
Authors: El Masry Ayman Mohammad , Zaki Mina Sameh , AbdAllah AbdelRahman Mohamed Ahmed Helmy Mohamed 
Published: November 2024

Abstract

Background
The choice between cement spacer and endprosthesis in the treatment of metastatic lesions to the proximal humerus is increasingly controversial. However, it may be easier to categorize the patients, their socioeconomic and perioperative parameters into two groups.

Aim of the Work
This work aims to review the available literature on the topic of endprosthetic replacement versus cement spacer in the reconstruction of the proximal humerus following metastatic lesions to the proximal humerus regarding the surgical technique, its indications, its advantages and limitations.

Patients and Methods
We followed the PRISMA statement guidelines during this systematic review, and performed all steps according to the Cochrane Handbook of Systematic Reviews of Intervention.

Results
Four studies were included in this systematic review, a total of 100 patients were included (22 of which had cement spacer and 78 had endprosthesis). Several parameters were compared in the reviewed studies including the MSTS score of the patients; the primary tumor; postoperative complications; the patients’ age; follow-up periods; and the presenting symptoms of the patients.

Conclusion
The choice of whether to use an endprosthesis or a cement spacer depends on dividing the patients into two groups. Endprosthetic replacement is an appropriate choice for patients with preserved deltoid and axillary nerve function following resection; solitary and non-aggressive metastatic lesion; long- life expectancy with minimal co-morbidities. Cement Spacer is a more appropriate choice in patients with non-functioning deltoid or axillary nerve following resection; multiple and aggressive metastatic lesions; short life expectancy with many co-morbidities, and poor socioeconomic status.
Results of Anterior Cruciate Ligament Reconstruction with and without Lateral Extra-Articular Tenodesis between High Demand Patients: Randomized Controlled Trial
Authors: Hady Amr Mohamed Abdel , Sobhy Mohamed Hassan , El Abd Mostafa Aly , Haroun Yahia Mohamed , Salam Abdel Halim Ahmed Abdel 
Published: November 2024

Abstract

Background
Rupture of the anterior cruciate ligament (ACL) is a serious and common injury among recreational sport players and high demand patients as manual workers. One of the causes of recurrent graft failure and need to revision surgery is persistent anterolateral instability following traditional ACLR surgery.

Patients and Method
This is a prospective, randomized clinical trial comparing the failure rate of an arthroscopic anatomical single-bundle ACLR with or without LET performed using Lemaire technique in a comparable patient population of high demand patient with isolated ACL tear. Patients 40 years or younger with an ACL-deficient knee were included and also had to meet the following 3 criteria: (1) high demand patients (athlete, manual worker,…), (2) isolated ACL tear, (3) and grade 2 pivot shift or greater. The primary outcome was ACLR clinical failure, a composite measure of rotatory laxity or a graft rupture. Patients were reviewed at 3, 6 and 12months postoperatively.

Results
From December 2020 till December 2022, 41 patients were included in our study. The patients randomized in two groups. Group A included 20 patients who underwent arthroscopic anatomical single bundle ACLR combined with LET by modified Lemaire technique. Group B included 21 patients underwent anatomical single bundle ACLR only. There were 2 patients lost during follow up excluded from statistical analysis in group B. So, in total 20 patients in group A and 19 patients in group B were available for follow for 12 months. In comparison between both groups regarding rotatory laxity assessed by Pivot shift test, all patients in group A (20/20) showed negative pivot shift tests, while (18/19) patients in group B (94.74%) showed negative pivot shift. Only one patient (1/19, 5.26%) (failed case) examination showed grade 2 pivot shift test. Regarding antero-posterior laxity measured by KT1000, there are statistically insignificant differences in favor to group A than group B during follow up at 3,6,9,12 months. However, Patients included in group A showed statistically significant improvement of side-to-side KT1000 difference at 12 months follow than patients included in group B (P = 0.002). Regarding failure rate, no failed cases included in group A. while, there was only one case (1/19) failed in group B (5.26% failure rate) with no statistically significant difference between the 2 groups.

Conclusion
The addition of the modified Lemaire LAET technique to anatomical single bundle ACLR showed statistically significant improvement in side-to-side anteroposterior laxity measure by KT1000 Lachmeter. While there is no statistically significant reduction in the failure rate between combined and isolated ACLR.