bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Microneedling, Platelet-Rich Plasma, and Combined Microneedling and Platelet-Rich Plasma in Treatment of Vitiligo
Authors: Lotfy Rania Adel , Elaal Nadia Omara Abd , Elnahas Khaled Ahmed 
Published: November 2024

Abstract

Background
Vitiligo is an acquired pigmentary disorder resulting from loss of melanocytes which causes depigmentation of the skin. Clinically, it is characterized by the progressive loss of melanocytes causing the appearance of well-circumscribed milky white cutaneous macules and patches.

Aim of the Work
To evaluate and compare the efficacy and safety of microneedling, platelet rich plasma (PRP) and combined PRP and microneedling for patients with stable vitiligo.

Patients and Methods
This study is randomized clinical trial. It was conducted on 225 stable vitiligo lesions. All patients were selected from the dermatology outpatient vitiligo clinic of Ain Shams University hospital from November 2020 to May 2022. All subjects who participated in this study gave written informed consents. The study was approved by the research ethical committee of Ain Shams University and fulfilled all the ethical aspects required in human research.

Results
A significant reduction was demonstrated through vitiligo analysis by computer-assisted grid (VACAG) in microneedling group only than other. There was no or minimal side effects in microneedling group. Regardless of the modalities, better improvement was seen in the neck followed by the trunk then lower limbs and the least improvement was in the upper limp.

Conclusion
according to our study, microneedling achieved superior repigmentation than combined PRP and microneedling. However, PRP alone showed poor improvement. Microneedling could be used safely and effectively in treatment of refractory NSV.
Intralesional Quadrivalent Human Papilloma Virus Vaccine Antigen Injection in the Treatment of Genital Warts: Clinical Evaluation and Effect on Serum and Tissue Interferon Gamma
Authors: Mohamed Salem Samar Abdallah , Elfattah Afify Ahmed Abd , Elhady Ahmed Walid Abd , Awad Gendia Sarah Ahmed 
Published: November 2024

Abstract

Background
Introduction: Genital warts or condyloma accuminata - are raised lesions that develop on the skin and mucous membranes due to infection with some types of human papillomavirus (HPV). Human papillomavirus infection is one of the most common sexually transmitted diseases and it is detected at least once in the lifetime of most sexually active people. Despite various treatment options currently available, many patients experience persistent and refractory disease. We sought to evaluate the clinical effectiveness and safety profile of intralesional quadrivalent HPV vaccine (Gardasil) for the treatment of genital warts.

Aim of the Work
This study aimed to evaluate the clinical efficacy of intralesional quadrivalent Human Papilloma Virus vaccine in the treatment of genital warts and assess its impact on serum and tissue IFNγ before and after treatment.

Patients and Methods
This study included 10 female patients with ano genital warts. They received intralesional gardasil, (0.3 ml) one injection session every 2 weeks for maximum 4 injection sessions. All the patients were recruited from the Dermatology, venerology outpatient clinic at El Houd el Marsoud Hospital during the period From May 2022 to August 2022. The lab part of the study was done at clinical pathology departement at Ain Shams University. All patients were subjected to clinical examination, photographic examination at first visit before any treatment and at each follow up visit, follow-up of patients were carried out at two-week intervals for 3 months to assess clinical response and complication(s) of injection. IFN-γ was asseyed by enzyme-linked immunosorbent assay (ELISA) using human IFN-γ ELISA Kit. Then quantitative determination of human IFN-γ concentrations were recorded.

Results
There was a highly significant decrease in the median number of lesions throughout the different sessions as compared to the baseline. The median number of lesions decreased from 14 at the baseline to 12, 10, 8 and 4 at the 2nd, 3rd, 4th sessions and last visit respectively. There was significant decrease in size of the largest injected wart after each treatment session compared to base line. The median size decreased from 1.25 cm at the baseline to 0.4, 0.2, 0.2 and 0.1 cm at the 2nd, 3rd, 4th sessions and last visit respectively.

Conclusion
the current study showed that intralesional HPV vaccine (gardasil) is an effective treatment modality in treatment of genital warts. INF-γ is considerd a good indicator factor for immune mechanisms needed for wart clearance.
A Meta Analysis to Identify the Extent of Thyroidectomy in Advanced Cancer Larynx
Authors: Yassin Omar , Sabra Reda Mohamed , Marmoush Abdelrahman Tarek Saeed , Fadel Michael 
Published: November 2024

Abstract

Background
Laryngeal cancer is a prevalent malignancy in the head and neck region, often diagnosed at an advanced stage. The role of thyroidectomy in managing advanced laryngeal squamous cell carcinoma (LSCC) remains controversial due to inconsistent findings regarding the incidence and predictors of thyroid invasion.

Aim of the Work
This systematic review and meta-analysis aimed to assess the incidence of thyroid invasion in patients with advanced laryngeal cancer and identify risk factors for thyroid invasion to clarify the indications for thyroidectomy. The study also sought to reduce the incidence of postoperative hypothyroidism and provide guidance for individualized treatment approaches.

Patients and Methods
A comprehensive search was conducted, and six studies involving a total of 852 patients were included in the meta- analysis. Data regarding patient demographics, tumor characteristics, and incidence of thyroid invasion were extracted and analyzed.

Results
The meta-analysis revealed a mean age of 57.7 years among patients with advanced laryngeal cancer, with a male predominance of 94.6%. The overall incidence of thyroid invasion among patients undergoing total laryngectomy was 13.3%. Subglottic tumor site and T4 classification were identified as significant risk factors for thyroid invasion, while supra glottis and glottis tumor sites, as well as T3 classification, were associated with reduced risk. The odds ratio for thyroid invasion was highest for patients with T4 stage tumors.

Conclusion
Thyroidectomy during total laryngectomy should be considered for patients with subglottic tumor sites and T4 classification due to the increased risk of thyroid invasion. However, for patients with supra glottis or glottis tumor sites and T3 classification, the thyroid gland may be preserved to reduce the risk of postoperative hypothyroidism. Further research is warranted to refine the surgical indications for thyroidectomy in patients with advanced laryngeal cancer.
Piezoelectric or Conventional Osteotomy in Rhinoplasty? A Clinical and Radiological Review of Fracture Lines Outcomes
Authors: Abdalrahman Aram Othman , Shafik Amr Gouda , Ahmed Aya Yassin , Maarouf Ahmed Mahmoud , Waheeb Mina Fayez 
Published: November 2024

Abstract

Background
Osteotomy of the nasal bones is the most challenging and critical step in rhinoplasty. The shaping of the nasal bony structures is the key for a successful operation. Mobilization of nasal bones along with minimizing the damage of supporting tissue and avoiding the excessive narrowing are the main goals of lateral osteotomy. Various techniques for lateral osteotomies have been described in order to reach the desired aesthetic and functional results, with reduction of soft tissue damage during rhinoplasty as the major goal. Piezoelectric surgery has been presented as a new method to be used during osteotomies, which takes advantage of ultrasonic piezoelectric vibrations in order to decrease the severity of morbidities. Its ability to minimize tissue trauma and its associated morbidity, along with its cutting effectiveness, has rendered piezosurgery popular for several clinical applications in various surgical fields during the last decades.

Aim of the Study
The basic aim of our study is planned to compare the postoperative fracture line criteria of the conventional and piezoelectric osteotomy in rhinoplasty and clinical examination to assess pain, edema and ecchymosis at day 1, 3, and day 7 and will be compared between left and right side in the same case.

Patients and Methods
Interventional clinical trial study for twenty patients eligible for rhinoplasty surgery subsequently undergo median, lateral osteotomy by a conventional osteotomes on right side and with an piezoelectric device for the left side, post-operative: Axial, coronal, sagittal and 3D reformat ct scan images 0.625mm thickness was done in on nasal bone to asses fracture line, in addition: postoperative pain assessed by a ten- point scale was applied, and edema with ecchymosis was assessed by visual analogue scale.

Results
Piezoelectric device in osteotomy step was associated with less pain, edema, ecchymosis and finer fracture lines outcome in comparison to traditional technique osteotomies in rhinoplasty.

Conclusion
Traditional osteotomies cause more tissues damages as a result more pain, more edema, and ecchymosis. The fracture line in piezoelectric side was accurate and more precise with regular and finer borders.
Comparison of the Outcome between Lateral, Perimodilar and Midscalar Electrodes in Cochlear Implantation Surgery: A Systematic Review
Authors: Abdallah Mohamed Shoeib Sara Ashraf , Ibrahim Samer Ahmed , Sobhy Tamer Shoukry , Abdelmoneim Teaima Ahmed 
Published: November 2024

Abstract

Background
Cochlear Implants are neuroprosthetic devices that are surgically implanted receiver-stimulator package and electrode array, which when used with external sound processor can produce a sensation of sound in the recipient in people who are deaf and can't benefit from acoustic hearing aids or middle ear implants or bone conduction devices.

Objective
To compare Lateral, Midscalar, and Perimodiolar electrodes, by using a systematic review as regards: trauma to the cochlea, hearing preservation (if there is a residual hearing).

Material and Methods
The search on Google Scholar, Scopus and PubMed using the following keywords (lateral wall electrode, Midscalar electrode, perimodiolar electrode, cochlear implant, hearing preservation, cochlear trauma).
The inclusion criteria: randomized control, case control, retrospective studies, human living patients, patients with profound sensory neural hearing loss (SNHL). The quality of relevant studies was assessed by NIH quality assessment tool for the type of study (“Study Quality Assessment Tools/National Heart, Lung and Blood Institute (NHLBI),”2019). 186 articles were yielded, from which 77 articles met our criteria. After duplicates removal and restricted to English language, 67 articles were screened in title/Abstract screening, while 31 articles were screened in full text screening were included.

Results
Our study showed that hearing preservation rate with lateral electrode was 53%. Also, hearing preservation with Mid-Scala electrode was 58%. Ratio of cochlear trauma with Perimodiolar electrode was 29% (7%, 55%). Hearing preservation with Lateral electrode versus Perimodiolar electrode odds ratio was 2.20 favoring lateral electrode over Perimodiolar electrode. Hearing preservation with Lateral electrode versus Mid-Scala odd ratio was 0.79 favoring no electrode type over the other. Preserving functional residual hearing in cochlear implant is higher in lateral electrode and Midscalar than in Perimodiolar electrode.

Conclusion
Preserving functional residual hearing in cochlear implant is higher in lateral electrode and Midscalar than in Perimodiolar electrode.
Ethical Challenges Facing Healthcare Workers during Pandemics (The Learned Lessons from Covid-19)
Authors: Elsheikh Amany A , Hamed Hanan , Azab Sonya M S , Tawfik Walaa Talaat 
Published: November 2024

Abstract

Background
The COVID-19 pandemic has raised a host of ethical challenges. In Egypt, the circumstances were more complicated due to limited resources and lack of training to face crisis circumstances which increased the burden of the crisis on the health care workers (HCWs) all over the country. However, to date, there is no sufficient studies of the ethical issues that have been raised during COVID-19 pandemic in Egypt.

Aim
This qualitative study aims to explore the ethical challenges faced by HCWs during COVID 19 pandemic, and to discuss their related background and contributing factors in the local community.

Methods
The study included 34 HCWs working in 12 governmental health care facilities in different governorates in Egypt. Semi- structured interview questionnaire was used for data collection.

Results
The HCWs reported the following main ethical challenges that faced them throughout the provision of care for COVID-19 patients: ‘balance between their duty of care of COVID 19 patients and fear of infection’, ‘uncertainty in management of COVID 19 cases’, ‘lack of organizational support during the pandemic”, ‘rationing the scarce health care resources’, ‘social stigmatization’ and ‘psychological burden of the pandemic’.

Conclusions
The present study portrayed the main ethical issues and challenges faced by HCWs during the pandemic. It is mandatory for health care authorities to adopt appropriate measures to resolve these issues and increase their preparedness in the era of pandemic to handle any crisis in the future.
Construction of a Crucial Score to Predict the Outcome of Patients with Aluminum Phosphide Poisoning at the Poison Control Center, Ain Shams University Hospitals (PCC-ASUH)
Authors: Zaki El seaidy Fatma Fawzy , Abou Anza Rasha El Hussaini , Mohamed Rania Hussien 
Published: November 2024

Abstract

Introduction
Acute aluminum phosphide (ALP) poisoning has become a major toxicological challenge in developing countries due to increasing mortality rate and absence of specific antidote. The aim of this study was to “Evaluate the value of APACHE II and SOFA scores in the prediction of outcome in patients with acute ALP poisoning and construct a predictive model for ALP poisoning”.

Subjects and Methods
A prospective cross sectional study of acute ALP poisoned patients admitted to the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH) during the period from August 2022 to April 2023. Patients’ data were collected in a patient sheet and included sociodemographic data, clinical and laboratory data of APACHE II and SOFA scores, ECG evaluation and the outcome. Receiver operating characteristic (ROC) curve analysis, univariate and multivariate logistic regression analysis have been applied for data analysis.

Results
A total of 110 ALP poisoned patients were evaluated with 52 survivors and 58 non-survivors. Evaluating the predictive value of APACHE II and SOFA scores, the cut off point of APACHE II score was &gt; 6 and AUC was 0.969 achieved 98.28% sensitivity and 86.54% specificity. The cut off point of SOFA score was &gt; 2 and AUC was 0.983 achieved 100% sensitivity and 86.54% specificity. Univariate and multivariate regression analysis revealed that six factors were the most significant predictive factors of mortality: PO2, PH value, Glasgow coma scale (GCS), Mean arterial pressure (MAP), HCO3 level and abnormal ECG. They were valid to construct the predictive new score at cut off value of PO2 &lt; 90% mmHg, PH &lt; = 7.28, GCS &lt; =12, MAP &lt;70 mmHg, HCO3 &lt; = 12.6 mEq/L. Scoring system was constructed of these six parameters each take a constant logistic score to give a total score of 33. The power of the predictive new score to discriminate between survivors and non-survivors at cut off &gt; 19 was excellent (AUC: 0.999) that achieved 96.55% sensitivity and 100% specificity.

Conclusion
High sensitivity and specificity values with excellent AUC reflect the usefulness of the new predictive score and recommended its use at emergency room as it is simple, quick, easy to use and appliciable even in small hospitals to predict the outcome of acute ALP poisoned patients.
Medicolegal and Ethical Considerations in Telemedicine: Survey of Physicians’ Knowledge, Attitude and Practice, Cairo
Authors: Ramadan Magda Mokhtar , Azab Sonya M S , Salem Hanan El-Sayed , Shaaban Tasneem Ragab 
Published: November 2024

Abstract

Background
Telemedicine has been utilized by healthcare providers for many years, but its widespread implementation did not occur until the onset of the COVID-19 pandemic. As telemedicine has grown, the related legal and ethical issues have emerged and the concerns about its regulation is increasing.

Objective
The study aimed to assess physicians’ knowledge, attitude and practice regarding telemedicine use and its legal and ethical considerations.

Methods
An online self-administered structured questionnaire was used for data collection. The respondents were 434 physicians working in different governorates in Egypt.

Results
Most of the participants reported using telemedicine for consulting a colleague from another specialty (93.8%, 407) or the same specialty (89.4%, 388); medical education (81.1%, 352) and management of the patients (73%, 317). Knowledge and attitude scores of participants working in university hospitals were significantly greater than that for other participants. About 57% of the respondents (142 physicians) reported incidence of complications related to using telemedicine, and patient’s inability to describe his condition was reported as the most common cause of complications (97%, 244).

Conclusion
Participants’ knowledge about ethical and legal considerations related to telemedicine was sufficient. Although most of them agreed with the advantages of telemedicine, they have negative attitudes toward its use in patients’ management.
A Systematic Review of Prophylactic Central Neck Dissection on Short-Term Locoregional Recurrence in Papillary Thyroid Carcinoma in Clinically Node Negative Patients after Total Thyroidectomy
Authors: El Sayed Osama Mahmoud , Nageeb Ramy Mikhael , Ragheb Ayoub Bishoy Refaat , Abdel Hafez Ahmed Mahmoud 
Published: November 2024

Abstract

Background
Thyroid cancer, notably papillary thyroid carcinoma (PTC), is a global health concern, warranting effective treatment strategies. The role of prophylactic central neck dissection (PCND) in clinically node-negative cases remains a subject of debate.

Aim of the Work
This study aims to conduct a systematic review and meta-analysis to evaluate the impact of total thyroidectomy with and without PCND on locoregional recurrence (LRR) and postoperative complications in PTC patients without clinically evident nodal metastasis (cN0).

Patients and Methods
Eight relevant studies from the past decade, encompassing 11,049 participants, were included in the analysis. The study focuses on outcomes related to recurrence rates, postoperative complications, and associated factors.

Results
The analysis suggests a trend toward a reduced recurrence rate with PCND following total thyroidectomy in clinically node-negative PTC cases, although statistical significance is not reached. Postoperative complications, including permanent hypoparathyroidism and laryngeal nerve palsy, are higher in the PCND group but do not show a statistically significant difference.

Conclusion
Prophylactic central neck dissection following total thyroidectomy appears to have a potential impact on reducing recurrence in clinically node-negative PTC cases. However, the study emphasizes the need for further research to validate these findings and explores the long-term advantages of PCND in conjunction with evolving surgical techniques.
A Comparative Study Between Thyroid Surgeries and Image Guided Thyroid Ablation in Benign Thyroid Nodules – A Meta-Analysis
Authors: Mohamed Abd El-Majeed Shabaan Mohamed , El Din Abd El-Monem Aly Ayman Hossam , El-Maksoud Nouh Ahmed Ahmed Abd 
Published: November 2024

Abstract

Background
Nodular thyroid disease is very common in clinical practice, discovered by palpation in 3 to 7% and by ultrasound (US) in about 50% of the general population. The aim of this work to compare and evaluate the indications, efficacy, morbidity and post-operative complications of Image Guided Ablation in comparison to thyroid Surgeries

Methods
This study involved a systematic review with a meta-analysis conducted on English-language retrospective or prospective studies available on PubMed from the past 5 years. Focused on patients aged 18 years or older who had undergone either thyroid surgery or image-guided thyroid ablation. Patients were categorized into two distinct groups: Group A undergone thyroid surgery, and Group B, undergone image-guided thyroid ablation

Results
There was a significant difference regarding age and nodule volume of the two groups. with insignificant difference regarding sex and nodule parameter. Incidence of hoarseness and postoperative pain were significantly lower in the thermal ablation (TA) group than in the conventional thyroidectomy group. No heterogeneity with hoarseness while a significant heterogeneity was in postoperative pain. Incidence of hypothyroidism was not significantly lower in the TA group than in the conventional thyroidectomy group with a significant heterogeneity. In terms of symptom improvement, the difference was insignificant with low heterogeneity. TA yielded significantly better postoperative cosmetic effects than conventional thyroidectomy with no heterogeneity, also associated with a shorter hospitalization time with a significant high heterogeneity

Conclusions
TA may be a favorable alternative to thyroidectomy, offering comparable outcomes with reduced morbidity and improved cosmetic satisfaction
Evaluation of the Role of Laparoscopic Sleeve Gastrectomy and Laparoscopic One Anastomosis Gastric Bypass in the Treatment of Metabolic Syndrome
Authors: Shatla Mahmoud Gamal Mohamed , El Aziz Mohammed Magdy Abd , Fouad Helmy Ramy 
Published: November 2024

Abstract

Background
The dramatic rise in the prevalence of Metabolic Syndrome has become a major global health issue. The problem is complex and will require strategies at many levels to prevent, control and manage. It is well known that obesity has profound effect on tissue sensitivity to insulin and so, leads to glucose intolerance, increased in Blood Pressure and abnormalities in Lipid Profile.

Patients and Methods
We aimed to compare between laparoscopic mini-gastric bypass and laparoscopic sleeve gastrectomy regarding the efficacy of control of type 2 D.M, Hypertension and Hyperlipidemia in obese patients. It is a prospective study which was done between April 2022 – October 2022 at Ain Shams university hospitals, Cairo, Egypt. This study included 60 obese patients with type 2 D.M with one or both of the following (Hypertension and Hyperlipidemia) and divided into two groups: Group (1): (30 patients) treated by laparoscopic Sleeve gastrectomy, group (2): (30 patients) treated by laparoscopic One anastomosis- Gastric Bypass.

Results
Complete resolution of diabetes occurred in OAGB cases in 66.7% compared to 55.4% in SG cases at 6 months and cases with no remission in D.M was 0% in OAGB and 16.6% with SG. Regarding the Hypertension, in Group 1 (SG) Resolution Of Hypertension was 55%, Improvement was 25% and No Change in Hypertension Status was 20%, In Group 2 (OAGB) Resolution Of Hypertension was 62.5%, Improvement was 25% and No Change in Hypertension Status was 12.5%, with comparing the 2 groups. Regarding Hyperlipidemia. In Group 1 (SG) Resolution Of Hyperlipidemia was 48%, Improvement was 30% and No Change in Hyperlipidemia Status was 22%, In Group 2 (OAGB) Resolution Of Hyperlipidemia was 60%, Improvement was 24% and No Change in Hypertension Status was 16%.

Conclusion
Bariatric surgery (SG and OAGB) is not only weight reducing surgery but a metabolic surgery which can cure most of the metabolic syndrome and they are considered the most effective long term treatment modality for type 2 diabetes in obese patients and with comparing between SG and OAGB, our study suggests that Both procedures are highly effective in control of Diabetes, Hypertension.