bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Autologous Cartilage Augmentation of Posterior Pharyngeal Wall in Management of Velopharyngeal Insufficiency A Meta-Analysis study
Authors: Samny Talat Ali Hassan El , Askoura Anas Mohamed Ali Nasr , Kamel Abdel Aty Ahmed Mohamed , Hosney Akram Hany Mohammed 
Published: November 2024

Abstract

Background
Velopharyngeal dysfunction is a disorder of the velopharyngeal sphincter or valve, which functions to separate the nasal and oral cavities during speech, swallowing, vomiting, blowing, and sucking. When the soft palate and pharyngeal walls are unable to form an effective seal, an abnormal connection between the nasal and oral cavities leads to hypernasal speech, increased nasal resonance, nasal regurgitation, nasal emission, and decreased intraoral pressure during speech. The overall result is decreased speech intelligibility and significant functional and social impairment.

Objective
To assess the efficacy of autologous cartilage augmentation of posterior pharyngeal wall in the treatment of velopharyngeal insufficiency.

Patients and Methods
An electronic database search (PubMed, SCOPUS, Embase, Web of Science, and the Cochrane database) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted with the goal of identifying all available studies related to use of cartilage graft in posterior pharyngeal wall augmentation in Velopharyngeal insufficiency to 2022.

Results
Rate of improvement in nasal hyper resonance was 82%. Rate of improvement in speech intelligibility was 85%. Rate of improvement in velopharyngeal closure was 76%. Rate of improvement in nasal emission was 61%.

Conclusion
We conclude that cartilage augmentation of posterior pharyngeal wall is appropriate for patients with minimal velopharyngeal gap and is effective for improvement of velopharyngeal closure and speech.
Development of a Screening Tool for the Impact of Children’s Feeding/Swallowing Problems on Their Caregivers
Authors: El Fattah Elattar Marwa Mahmoud Abd , Nassar Jilan Fouad , Khattab Ahmed Nabil , ElFiky Yomna Hassan 
Published: November 2024

Abstract

Background
Health-Related Quality of Life (HRQOL) has been established as an important gauge of patient-based health outcomes. It has emerged as an important health outcome in clinical trials and healthcare research, for which HRQOL assessment instruments have played an important role.

Aim of the Work
the aim of this study is to develop a screening tool to measure the impact of children’s feeding/swallowing difficulties on their caregivers, as understanding the specific concerns of these caregivers may provide health care providers and funding sources with information about management recommendations and this ultimately improves the care provided.

Patients and Methods
This study is a cross-sectional study, the 26-item Arabic Egyptian Feeding/Swallowing Disorder Impact Questionnaire (AEFSDIQ) was administered to 150 caregivers whose children complaining of feeding/swallowing disorders and coming to our Phoniatrics unit for first evaluation or follow up.

Results
Validation of the Caregiver Impact Questionnaire was done. Internal consistency reliability of the full scale was demonstrated by Kuder-richardson KR20 Reliability coefficient and it was equal 0.744 which indicated that the constructed questionnaire homogenous and is likely to produce consistent responses, which proved good reliability of the questionnaire.

Conclusions
This study presents a comprehensive, valid and reliable tool that can assess the impact of feeding/swallowing disorders on their caregivers. Caring for these children adversely impacts the QOL of caregivers. Clinicians can deliver better services by identifying and paying appropriate attention to factors that influence the QOL of caregivers of children with feeding/ swallowing problems.

Recommendations
From the course of the present study, we recommend that further multicenter studies with larger sample size could be of value for assignment of this questionnaire.
Efficacy of Nasal Steroid Irrigation in Chronic Rhinosinusitis after Sinus Surgery: A Meta-Analysis Study
Authors: El-Gabry Merna Mostafa Mohamed , Sabry Sabry Magdy , Fawzy El-Beltagy Yasser Mohamed , Teaima Ahmed Abdelmoneim 
Published: November 2024

Abstract

Background
Chronic rhinosinusitis (CRS) is a frequent multifactorial inflammatory disorder that ranges from single sinus disease to extensive sinonasal airway inflammation that reduces the patient's quality of life. The goal of CRS treatment is to decrease infectious exacerbations while controlling inflammation.

Methods
We conducted a meta-analysis study to assess the efficacy of nasal steroid irrigation in CRS after sinus surgery. This study included published medical articles from 1990 till 2023 concerning the efficacy of nasal steroid irrigation in CRS after sinus surgery through the Medline data base (PubMed), Web of science, Springer, Cochrane library, EMBASE.

Results
Sixteen studies (n = 678) met the inclusion criteria and were reviewed and analyzed. Nasal steroid irrigation resulted in statistically highly significant improvement (p &lt; 0.01) in both SNOT and LKES at 6 and 12 weeks, and 12 months evaluation after surgery, in SNOT only at 6 months evaluation and in LKES only in 2 weeks evaluation. The improvement in SNOT was statistically significant (p = 0.04) at 2 weeks evaluation, however, there was no statistically significant improvement (p = 0.18) in LKES at 6 months evaluation after surgery. When compared to saline alone irrigation, steroid irrigation resulted in highly statistical improvement in (p &lt; 0.01) in SNOT at 6 weeks and in LKES at 2 weeks and 12 weeks evaluation. It also resulted in statistically significant improvement in SNOT at 2 weeks (p = 0.01) and 12 weeks (p = 0.02) and in LKES at 6 weeks (p = 0.01) and 12 months (p = 0.02), However the improvement wasn’t statistically significant at 6 months (p = 0.35) and at 12 months (p = 0.95) in SNOT and at 6 months (p = 0.10) in LKES.

Conclusion
The addition of steroid to normal saline for nasal irrigation in CRS patients who underwent functional endoscopic sinus surgery is more effective than saline alone irrigation both subjectively and objectively over short-term follow-up visits.
Role of Transoral Robotic Surgery in Treatment of Oropharyngeal Carcinoma
Authors: Al Kahky Ayman Mohamed Othman , Hassan Mohamed Amir , Maarouf Ahmed Mahmoud , Aziz Shafei Hamza Rania Mohamed Abdel 
Published: November 2024

Abstract

Background
Transoral surgery in the oropharynx is a surgical strategy for directly accessing and resecting oropharyngeal tumors through the mouth. Direct access to the tumor, as opposed to transcervical approaches, helps avoid the morbidity of open approaches and thus allows for faster recovery of the functions, the most important of which is swallowing.

Aim of the Work
The aim of this work is to provide cumulative data about the efficacy and safety of transoral robotic surgery (TORS) and long term oncologic and the functional outcomes of TORS in treatment of oropharyngeal carcinoma by doing a meta-analytical study.

Materials and Methods
This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. This meta-analysis was conducted to provide cumulative data about the efficacy and safety of transoral robotic surgery (TORS), and long-term oncologic and functional outcomes of TORS in the treatment of oropharyngeal carcinoma. We enrolled 12 studies that studied the outcome of TORS surgeries of oropharyngeal carcinoma patients. These studies contained 4460 patients with 3688 male patients and 772 female patients with a male-to-female ratio of 5.1/1.

Results
Our meta-analysis showed that the pooled (disease free survival rate) in random effect model was 86.2% and in random effect model pooled (overall survival rate) was 90.3%. Our meta-analysis showed that in oropharyngeal carcinoma patients in random-effects models the pooled (local recurrence rate) was 2.6%, for regional recurrence rate was 3.5% and for distant recurrence rate was 3.2%.

Conclusion
These findings showed that TORS had a better locoregional control rate than different treatment modalities. this difference was due to differences in tumor stage and site in different studies and used techniques. Regarding the prolonged gastrostomy tube dependence rate, this meta-analysis showed that the rate was 6.1% in the random-effects model.
Factors Affecting Adherence to Medications among Type2 Diabetic Patients Attending Primary Health Care Center in Cairo
Authors: Salama Hemat Abd El-Salam Ahmed , Shaltoot Heba Mohamed Hamed , Abdul-Rahman Samia Ahmed , Abd El-Hamid Diaa Marzouk 
Published: November 2024

Abstract

Background
Poor adherence to medications is a major public health problem. Non-adherence results in disease progression, reduced functional abilities, a lower quality of life, waste of medication and increase use of medical resources such as nursing homes, hospital visits and hospital admissions.

Objective
To measure the prevalence and factors affecting adherence to medications among T2DM patients attending primary health care center of Saraya El Quobba. To measure the agreement between MTA (Measure Treatment Adherence) and ARMS (Adherence to Refills and Medications Scale) questionnaires as a tool of measurement treatment adherence.

Methods
A Cross sectional study was carried out in family medicine center of Saraya El Qubba in Cairo on 130 participants who had been diagnosed T2DM at least3 months before. Patients with T1DM, Patients with known history of psychiatric illness or cognitive impairment, Patients with communication problems such as aphasia, severe hearing or visual impairment were excluded. Selection of participants was done through Systematic Random Sampling. Data about adherence was collected using structured questionnaires MTA (Measurement Treatment Adherence) and ARMS (Adherence to Refills and Medications Scale) questionnaires.

Results
62.6% of our sample were females, 38.9% belonged to age group of 60-70 years, 71.8% were married, 29% had intermediate education, 61.8% were unemployed. The level of adherence among patients attending primary health centre of Saraya El Quobba was 65.6%. Many factors were found to affect medication adherence as regular monitoring of blood glucose level (76.7%), regular follow up visit (75.9%), presence of family support (20.6), monthly income (84.2%) and educational level. There was a statistically significant strong negative correlation between the 2 measurements scores (r=-0.8644, p &lt; 0.001).

Conclusion
The level of adherence was high among the participants in the current study. Many factors were found to affect medication adherence as regular monitoring of blood glucose level, regular follow up visit, presence of family support, monthly income, both high and low educational level. Agreement between to questionnaires was found.
The Effect of Probiotic Lactobacillus acidophilus on the Management of Symptoms, Duration, and Disease Progression in Mild and Moderate COVID-19 Cases: A Randomized Controlled Clinical Trial
Authors: Hassan Samar Osama Ahmed , El-Din Hassan Ahmed Nour , Mohamed Manal Sabry , Al Ashram Mohamed Nabil Badawy , Nesim Mina Michael , Allam Mohamed Farouk 
Published: November 2024

Abstract

Background
COVID-19, a recently identified human disease resulting from a novel coronavirus, has led to a worldwide pandemic crisis. Considering their antiviral, anti- inflammatory, and immunomodulatory effects, probiotics emerge as potential treatment options.

Objective
To evaluate the efficacy of probiotic supplements, specifically Lactobacillus acidophilus, in managing symptoms, duration, and the progression of mild and moderate COVID-19 infections.

Methods
A randomized controlled clinical trial was conducted at the triage clinic of the Family Medicine Department at Ain Shams University Hospitals, involving 100 participants diagnosed with mild and moderate COVID-19 severity. Excluded from the study were individuals below 18 or above 65 years old, those with any co-morbidity, pregnant or lactating females, and confirmed cases of severe COVID-19. The randomization process involved sealed envelopes containing codes for either the intervention or control group. Patients are monitored for the alleviation of their symptoms, with attention to the absence of new symptoms emerging throughout a two-week period.

Results
The study included 100 patients with mild and moderate COVID-19 severity, evenly distributed with 50 patients in each group. Approximately one-third of participants were aged between 29 and 39 years, one-quarter were between 18 and 28 years, and 40.6% were aged 40 years and above. The average duration for symptom improvement was 11 days in the probiotic group and 12 days in the control group. Both groups exhibited improvement in inflammatory markers over time, with no statistically significant difference between them.

Conclusion
Probiotic Lactobacillus acidophilus demonstrates no substantial impact on the symptoms, duration, and progression of mild and moderate cases of COVID-19.
Sex Determination by Analyzing Morphometrics of Sella Turcica, Foramen Magnum and Mastoid Process Using Head and Neck Multislice Computed Tomography in Egyptian Population
Authors: Kamaleldin Omar N , Abdelaal Seham F , Abdelrahman Hazem I , Elsayed Emad A 
Published: November 2024

Abstract

Background
Identification of unknown individuals is fundamental in forensic studies, and is based upon the determination of sex, age, ethnicity and stature of individuals. Sella turcica, Foramen magnum and Mastoid processes can be used in forensic medicine to aid sex identification of living humans and their remains in severe conditions as mass disasters due to their position in the basicranium, which has a resistant nature and is a commonly preserved part of the human skeleton.

Aim
This study aimed to analyze and compare the parameters of the Sella Turcica, Foramen magnum and Mastoid processes for sex determination in adult and child Egyptian samples.

Methods
This is a Comparative cross-sectional study involving 120 Egyptian patients divided into 60 Adult cases and 60 Children cases, conducted in Radiology department - Ain Shams University Hospitals in Cairo, Egypt during the period from the beginning of August 2021 to the end of July 2022. Each group is subdivided into 30 males and 30 females. The Sella turcica, Foramen magnum and Mastoid processes parameters in multislice Computed Tomography (MSCT) scans were measured in all the cases, and findings were tabulated.

Results
The current study showed a significant statistical difference between males and females in adult cases as regards the anterior-posterior (A-P) diameter of sella turcica, the maximum width of the foramen magnum (FMW), the foramen magnum area (FMA), the maximum length of the right occipital condyle (LROC), the maximum length of the left occipital condyle (LLOC) and the mastoid area (P value&lt;0.05). In children cases there was a significant statistical difference between males and females as regards the Sella turcica length, the Sella turcica depth, (A-P) diameter of Sella turcica, the maximum foramen magnum length (FML), FMA and LLOC (P value&lt;0.05). the present study showed that the best single parameter in determining the sex of adult cases is mastoid area, and in children cases is FML.

Conclusion
A-P diameter of sella turcica, FMW, FMA, LROC, LLOC and mastoid area are more efficient than other parameters in determining the sex of adult cases, while the Sella turcica length, depth and A-P diameter, FML, FMA and LLOC are more efficient than other parameters in determining the sex of children cases.

Recommendation
Further studies are needed to assess the correlation of the Sella turcica, Foramen magnum and Mastoid process parameters with age and other ethnic groups with a larger sample size.
Evaluation and Comparison of the Accuracy of Nolla and Demirjian Methods for Age Estimation in a sample of Egyptian Children Using Panoramic Radiographs (A Retrospective Study)
Authors: El-Gaidy Sara A , Ramadan Magda M , Salem Hanan E , El-Oefy Omnia S , Bayoumy Raghdaa A 
Published: November 2024

Abstract

Background
Age estimation is an important procedure in forensic field. It is very crucial for the identification of both living and dead persons. For living it is performed in circumstances where the birth certificate is not available or the records are suspicious. This could be of value in civil conflicts e.g. marriage, employment, military recruitment, inheritance and adoption. Also it is important in criminal cases involving rape, kidnapping and illegal immigration, as well as for medical cases as pediatric endocrinopathy and orthodontic malocclusion. Age estimation of cadavers is performed in criminal cases, as well as for identification of mutilated victims of mass disasters, such as fires, crashes, accidents, feticides, homicides and infanticides.

Aim
Estimation the age of a sample of Egyptian children through using both Nolla and Demirjain methods, Comparison of these ages with their chronological ages and then assessing the accuracy of these methods in age estimation.

Methods
A retrospective study was performed on panoramic radiographs of 180 subjects aged less than 6–16 years. The mean dental age (DA) according to the Demirjian and Nolla methods were compared to the mean chronological age (CA).

Results
The mean CA of the study sample was 9.90±2.71 and 9.40±3.23 years for females and males, respectively. Using the Demirjian method, the mean estimated DA was 9.38±2.09 years for females and 9.77±3.01 years for males. For Nolla method, the mean estimated DA was 8.48±1.79 and 9.07±2.77 years for females and males, respectively. The mean differences between the CA and DA according to the Demirjian were -0.52 and 0.37 years for females and males, respectively. For Nolla method the mean differences were -1.42 and -0.33.

Conclusions
Nolla method was found to be a more accurate method for estimating DA in Egyptian population. The predictive ability of Nolla method by linear regression analysis was 98%.
Physicians' Knowledge, Attitude and Practice Regarding Medical Errors: Cross Sectional Study in Governmental Hospitals in Cairo
Authors: Hamed Hanan , Azab Sonya M S , Talaat Walaa , Hassan Shaimaa 
Published: November 2024

Abstract

Background
Medical errors are inevitable events in almost all healthcare settings and represent a major source of morbidity and mortality throughout the world. In Egypt, medical error is one of the most distressing issues facing the physicians due to absence of settled laws regarding medical malpractice litigations and unjustified social media which flare up any medical error without scientific criticism of the case. This study aimed to assess physicians’ knowledge and attitude toward medical errors and their reported incidence of medical errors and their leading factors.

Methods
This cross-sectional study was conducted on physicians working in governmental hospitals in Cairo, with duration of work experience equal or more than two years. An online self-administered structured questionnaire was used for data collection.

Results
The study included 580 physicians, with different specialties. There was no significant difference either in knowledge or practice score between the respondent physicians according to their personal characteristics. Diagnostic errors were the most common errors reported by the participants (either missed diagnosis 73.4%, delayed diagnosis 71.3% or wrong diagnosis 58.4%); followed by failure of communication (between medical staff 53.4% and with the patient 47.5%). Incidence of infection or contamination was the most reported surgical error (32.5%) and inadequate preoperative assessment and/or preparation of patient was the most common anesthetic error (27.7%). Regarding the resulting damage from the errors, 7.8% of the participants reported incidence of patient’s death, 4.7% of them reported incidence of severe physical damage, 26.6% reported by mild-to - moderate physical damage and 31.7% of them reported financial damage. Most of them reported defensive medicine practices.

Conclusions
Participants’ knowledge about medical responsibility was insufficient. Although most of them reported incidence of medical errors, they recommended establishment of guiding system helping them to disclose incidence of errors and taking actions to prevent them in the future.
Per-Oral Endoscopic Myotomy versus Heller Myotomy in Patients with Achalasia: Meta-analysis Study
Authors: Mohamed Ezz Reda Saad , Kamel Kareem Ahmed , Younis Mohamed Abdelrahman Ahmed 
Published: November 2024

Abstract

Background
Achalasia is a primary esophageal motility disorder of unknown etiology characterized manometrically by insufficient relaxation of the lower esophageal sphincter (LES) and loss of esophageal peristalsis in the absence of mechanical obstruction, radiographically by esophageal dilation with minimal LES opening ―bird-beak appearance, poor emptying of barium; and endoscopically by dilated esophagus with retained saliva, liquid, and undigested food particles in the absence of mucosal structuring or tumor

Objective
To compare the efficacy of per-oral endoscopic myotomy and heller myotomy in achalastic patients

Patients and Methods
We searched for all relevant studies published between January 2000 and September 2018 that examined the post- operative Eckardt score, perioperative outcomes, and acid reflux-related adverse events between POEM and HM, using MEDLINE, EMBASE, and the Cochrane Library data- bases. The following search string was used: ((POEM) or (endoscopic myotomy)) and ((laparoscopic myotomy) or (surgical myotomy) or (Heller myotomy) or (Heller’s myotomy)). The detailed search strategies in each database are shown in (available online at www.giejournal. org). In addition, we examined the references of the screened articles to identify additional studies. The date of our most recent search update was September 18, 2018.

Results
Our meta-analysis provides a better understanding of the comparative efficacy of POEM and HM in patients with achalasia. Although long-term follow-up data in this regard are currently insufficient and considerable heterogeneity was identified in the meta- analysis, the short-term efficacy of POEM was superior to that of HM. The length of myotomy was also greater in POEM than in HM. The operation time and length of hospital stay tended to be shorter in POEM than in HM, however the difference was not big between both. Erosive esophagitis tended to be more common in POEM as fundoplication cannot be done with it.

Conclusion
Although long-term follow-up data are insufficient, the short-term efficacy of POEM was superior to that of HM. Erosive esophagitis tended to be more common in the POEM group; however, there was no difference in reflux symptoms and pathologic reflux on pH monitoring between the groups.