bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Efficacy of L-Glutamine in Reducing the Frequency of Acute Complications Among Patients with Sickle Cell Disease: A Randomized Controlled Study
Authors: Mohamed Samah Mohamed Ahmed , Makkeyah Sara Mostafa , Aly Nihal Hussien , Okba Ahmed Ashraf Mahmoud , Shaheen Naglaa Mohammed , Ebeid Fatma Soliman Elsayed 
Published: November 2024

Abstract

Introduction
Patients with sickle cell disease (SCD) suffer from recurrent and unpredictable episodes of acute pain due to vaso-occlusive crisis (VOC) which may require hospitalization and they also develop chronic persistent pain. Since pain usually begins in infancy and continues throughout life, preventing the genesis of pain is comparatively higher than treating the pain once it has been evoked VOC represents the cause of almost 95% of hospitalizations for patients with SCD. L-glutamine is an amino acid needed for the synthesis of the pyridines for nucleotides, including nicotinamide adenine dinucleotide (NAD) and glutathione, in addition to glutamate, and becomes essential during oxidative stress exposure. The NADH: [NAD+ + NADH] (redox) ratio in sickle red blood cells (RBCs) is lower than in normal RBCs which is related to oxidative stress, so L-glutamine availability is important in SCD. Although the FDA-approved it for preventing acute complications in SCD, still has many gaps in our understanding of its therapeutic implications.

Aim
To evaluate the safety and efficacy of L-glutamine in reducing the number of VOCs in patients with SCD.

Methods
This is an investigator-initiated single-center phase 4 interventional randomized controlled trial at Ain Shams Pediatric Hematology Unit. Sixty SCD participants, their mean age was 9.2 ± 3.7 years, they were 35 males and 25 females, were randomly assigned in a 1:1 ratio to receive glutamine at a dose of 0.3 gm/kg/dose twice daily orally (up to a maximum of 15 g/dose) for 24 weeks or the standard of care (SOC) without glutamine intake.

Results
Thirty-seven (62%) had HbSS with 38% had other sickle cell variants. All participants were receiving HU therapy and were on stable dose during the last three months prior to enrollment. Almost half of the patients (48%) were on chelation therapy with deferasirox. Thirty SCD patients were recruited in each group either received glutamine or SOC, both groups were comparable as regards demographic data. All patients in both arms had VOCs in the last year more than two. For the primary endpoint, there was a decreasing trend in the number, severity, and hospitalization of VOC in the glutamine arm and there was a significantly lower cumulative number of VOCs in the glutamine group (38.9%) than SOC (52.8%) (p = 0.008) and lower cumulative number of hospitalizations (p &lt; 0.001).

Conclusion
Glutamine reduced the number of VOCs and hospitalizations for VOC in our cohort with SCD.
Levels of Tumor Necrosis Factor Alfa and Iron Status in Pediatric Patients with Newly Diagnosed Solid Tumors
Authors: El-Laboudy Mohamed Abd El-Mohsen , Makkeyah Sara Mostafa , Mohamed Sara Sobhy , Elwafa Menna Allah Zakaria Abou , Kader Salwa Mostafa Abd El 
Published: November 2024

Abstract

Background
Tumor necrosis factor alfa (TNF-α) plays a crucial role in the etiopathogenesis of cancer related anemia. Aim: To assess the levels of TNF-α, erythropoietin (EPO), and iron status in relation to anemia in children with newly diagnosed solid tumors.

Methods
we measured serum levels of TNF-α, EPO and assessed iron status using enzyme linked immunosorbent assay in 42 patients (20 non-anemia and 22 anemic) with newly diagnosed solid malignancies and compared them to 25 age- and sex-matched healthy controls.

Results
Among the 42 patients enrolled, 14 (33.3%) patients had brain tumors, seven (16.6%) were diagnosed with neuroblastoma, and four (9.5%) with Wilms tumor. The mean hemoglobin levels were 12.39±0.8 g/dl and 9.57±1.3 g/dl in non-anemic and anemic patients respectively. We found significantly higher levels of serum TNF-α and lower EPO levels among patients when compared to the control group (p &lt; 0.001). A post hoc analysis showed a significantly higher TNF-α and lower EPO levels among anemic versus controls (p &lt; 0.001) and non-anemic versus control (p &lt; 0.001). A significant positive correlation was found between both EPO and TNF-α in both anemic and non-anemic group (r = 0.48, p = 0.024) and (r = 0.44, p = 0.021) respectively. However, the median (IQR) levels of both TNF- α and EPO were comparable between both anemic and non-anemic patients (306 (237.5) pg/ml versus 353 (156.2) pg/ml, p = 0.47) and (93 (46) mIU/ml versus 87 (51) mIU/ml, p = 0.48) respectively. The median (IQR) levels of serum ferritin and transferrin saturation index (TSI), as well as; serum TNF-α did not correlate with any of the red cell indices yet; directly correlated with platelet counts (r = 0.491, p = 0.02).

Conclusion
Children with solid malignancies have significantly higher levels of TNF-α and impaired EPO responses than normal children, however, no significant effect was observed for either on hemoglobin and red cell indices. Whether the positive relationship between TNF- α and EPO suggest other mechanisms of TNF- α related anemia needs further studies.
Prefilled Saline Syringes versus Those Prepared at Bedside for Flushing Central Venous Catheters in Neonatal ICU
Authors: Imam Safaa Shafik , Ismaiel Elkomy Shereen Atef , Allam Rabab 
Published: November 2024

Abstract

Background
A central line-associated bloodstream infection (CLABSI) is defined as a laboratory-confirmed bloodstream infection not related to an infection at another site that develops within 48 hours of a central line placement. CLABSI is the most common type of nosocomial infection in this population and is a leading cause of morbidity and mortality in NICU. Therefore, more efforts are needed to reduce the incidence of CVC-related infections among NICU patients, and to enhance their survival and prognosis.

Aim of the Work
To compare the effect of using of prefilled saline syringes prepared in the laminar flow under complete aseptic conditions vs using ones prepared at bedside for central venous access flushing regarding risk of CLABSI, catheter permanence time, risk of thrombosis, and length of stay in our NICU.

Patients and Methods
This prospective randomized controlled trial in Ain Shams University Hospital NICU over a 6-month period from January 2023 till July 2023. They were selected through simple random sampling method to be divided into 2 groups:
Group 1 (cases): 50 patients had their CVCs flushed by 3ml syringe prefilled with saline 0.9% prepared in the laminar flow on the same day.
Group 2 (controls): 50 patients had their CVC flushed through manually prepared 3 ml syringe prepared at bedside from a common bottle of saline 0.9%.

Results
It was found that Group 1 patients had significantly lower incidence of CLABSI than Group 2 patients (4 versus 13 neonates) (p-value &lt;0.0001). The incidence of CVC thrombosis was shown to be less in Group 1, however, this difference was non-significant (2 versus 1 neonate) (p-value 0.557). This study showed there was no statistically significant difference between both groups regarding the catheter permanence time (8.56 ± 6.52 versus 10.46 ± 6.29) (p-value 0.146). There was no statistically significant difference between both groups regarding the length of hospital stay in studied patients, 26.5 (14 – 37) in Group 1 versus 25 (12 – 32) in Group 2 (p-value 0.704).

Conclusion
The use of prefilled saline syringes for flushing of central venous catheters in neonates has shown to significantly reduce the risk of CLABSI, reduce incidence of catheter- related thrombosis, and flushing time, thus improve quality of care in neonatal ICU.
Neonatal Modified Pediatric Risk of Mortality Scoring System III and Perfusion Index in Neonatal Intensive Care Units
Authors: Hassan Maha , Haseeb Walaa , Ibrahim Mariam 
Published: November 2024

Abstract

Background
Pediatric Risk of Mortality (PRISM) score III presents an excellent discriminatory performance and prediction, being used in many PICUs as a prognostic score to assess gravity of disease(Kaur et al., 2020). In our study we modified the PRISM score III variables to produce the neonatal modified PRISM score III (NM PRISM score III) using validated cut offs which were more specific to neonatal age to be able to predict risk of mortality in both preterm and full term neonates admitted to NICU. The perfusion index (PI), derived from the pulse oximeter signal, has been reported to reflect inadequate peripheral perfusion in critically ill newborns (Montiero et al., 2017). The combined use of NM PRISM score III and PI can be a helpful method in identifying mortality and morbidity in NICUs accurately.

Aim
to test the use of the NM PRISM score III in predicting risk of mortality in NICUs.

Methods
In this prospective observational study, we adjusted the PRISM score III to neonatal based parameters score; neonatal modified PRISM score III (NM PRISM score III) and applied it to 112 neonates admitted to NICU, Ain Shams university hospitals on day1 and day3 of admission using the most abnormal values of physiologic and laboratory data to calculate the score for patients who survived and patients who died. Perfusion index was also used as an adjuvant to the NM PRISM score III (combined use of NM PRISM score III and PI) as an indicator of peripheral circulation.

Results
There was a significant difference between patients who survived and patients who died for NM PRISM score III with median 4 and IQR 2.00-4.00 at day1 and median 3 and IQR 0.00-7.00 at day3, with p value &lt; 0.001 both at day1 and day3 of admission. By using ROC curve NM PRISM score III can be used to predict mortality at day3 as the area under the ROC curve at day3 was 0.975, with sensitivity 93.1% and Specificity 91.6%. The combined use of NM PRISM score III and PI at day3 of admission can also be used as it represented the best discriminative tool for predicting mortality as the area under the ROC curve at day3 was 0.980 with sensitivity 96.6 % and specificity 91.6%.

Conclusion
Combined use of NM PRISM score III and Perfusion index at day III can predict mortality accurately in critically ill neonates admitted to NICU.
Different Modalities of Coverage of Acute Dorsal Hand Defects (Meta Analysis Study)
Authors: Mahmoud Nada Abdelsattar , Ahmed Hassan Lashin Riham Zakaria , Abdelhalim Mohamed Mamdouh , Alkholy Abdelraouf Abdelaziz Tawfik 
Published: November 2024

Abstract

Background
Injuries to the dorsal aspect of the hand often result in exposed tendons, joints, nerves, and bones, presenting significant challenges for reconstructive surgery. Various techniques, including skin grafts, local flaps, and free tissue transfer, are utilized to address acute dorsal hand defects, with the primary goal of restoring functionality while minimizing aesthetic impact.

Aim of the Work
This study aimed to review and analyze outcomes from previously published papers to evaluate different flap modalities' efficacy in dorsal hand defect coverage.

Patients and Methods
A comprehensive review of the literature was conducted to identify studies reporting outcomes of flap procedures for dorsal hand defects. Included studies varied in sample size, demographic data, and follow-up duration.

Results
The analysis revealed the limitations of conventional skin flaps, leading to the emergence of thinner flaps and free flaps as alternative options. While free flaps have become the standard for their versatility, thinner flaps offer advantages in aesthetics and reduced need for debulking procedures. Patient satisfaction rates were generally high across modalities, although outcomes varied based on individual factors and surgical techniques. Aesthetic outcomes did not significantly differ between flap types, with venous flaps demonstrating superior visual outcomes.

Conclusion
Dorsal hand reconstruction poses challenges necessitating meticulous surgical planning and postoperative care. While various flap modalities offer viable options, continued research is needed to optimize outcomes and address individual patient needs effectively.
Evaluation of Bovine Scapular Cartilage as a Valid Training Model for Auricular Carving
Authors: Ragab Aya Essam Ahmed ElSayed , Hweidi Ahmed Sobhi , Bakry Sameh Adel Desawy , ElShahat Ahmed 
Published: November 2024

Abstract

Background
Nowadays, surgical reconstruction with autologous tissue is the most common clinical practice. The procedure requires a high level of manual and artistic techniques of a surgeon in carving and sculpting of harvested costal cartilage of the patient to recreate an auricular framework to insert within a skin pocket obtained at the malformed ear region. The aesthetic outcomes of the surgery are highly dependent on the experience of the surgeon performing the surgery. For this reason, surgeons need simulators to acquire adequate technical skills out of the surgery room without compromising the aesthetic appearance of the patient.

Aim of the Work
The objective of this study is evaluation of Bovine Scapular Cartilage as a Valid Training Model for Auricular Carving.

Patients and Methods
15 Bovine scapular cartilages were used by 16 trainees as training model for ear carving. Some of cartilages were cut to resemble the 8th floating rib and the other were cut to resemble syncytium. 3/0 prolene sutures, needle holder and surgical blade were used, also carving of framework was done by using either 2D xray film patron or 3D printed auricle.

Results
Bovine scapular cartilage model is a valid model to teach the carving of the ear for ear reconstruction surgeries. All of the participants were able to successfully carve a satisfactory ear framework by using the surgical blade also make a suture by 3/0 prolene tip round suture in the cartilage. Moreover, this cartilage gives good replica of human cartilage in consistency and flexibility as it was easy to carve in it the 8th floating rib and syncytium part.

Conclusion
Bovine scapular cartilage is considered an ideal model for training to achieve experience in auricular carving.
The Effect of Adding Stromal Vascular Fraction (SVF) to Hydrocolloid Dressing to Enhance Healing of Donor Sites of Split Thickness Skin Grafts
Authors: ElShahat Ahmed , AbdelGelel Mohamed Youssef , Mamdouh Mohamed , ElSherbeny Khaled M , Erfan Moatasem 
Published: November 2024

Abstract

Background
Wound healing is complex process, which requires suitable environment to enhance the healing process. With the advancement in technology, many new wound dressings have been introduced for use on split-thickness skin graft donor sites to treat different types of wounds by targeting various aspects of healing process. An ideal donor site wound dressing can reduce pain, lower the risk of infection, encourage hemostasis, and accelerate the healing process. This dressing would also be simple to manage, simple to apply in the operating room, and affordable. The use of hydrocolloid dressing to promote healing of donor site of STSG is a well-established technique.

Aim of the Work
The main aim of this study was to evaluate the effect of adding Stromal Vascular Fraction (SVF) to Hydrocolloid Dressing to enhance reepithelization and quality of scars of donor Sites of Split Thickness Skin grafts.

Patients and Methods
Twenty-seven post burn and post traumatic patients admitted to plastic, burn and maxillofacial department in Ain Shams University hospitals which need coverage with STSG were included in this study. A prospective comparative interventional self-controlled clinical study was conducted on donor sites of STSG, In which donor sites of STSG were divided into two equal halves where the upper half was injected intradermally with SVF with application of hydrocolloid dressing (group A), and the other half was covered with hydrocolloid dressing only (group B).follow up of reepithelization at donor sites were evaluated at day 10th, 15th, 21th and 1 month post harvesting of STSG also Vancouver scar scale was used to assess the quality of the scar after 1 month.

Results
The result showed that among the studied population 51.9% were males and 48.2% were females with mean age of the study population was 33.37 ± 9.55 years ranged from 18 to 52 years. 85.2% of patients had burn raw areas, while only 14.8% had post-traumatic raw areas. The comparison between (group A) and (group B) according to time for reepithelization by days, we found that (group B) needed more time for healing by (18.56 ± 4.69) compared to (group A) which need (11.33 ± 1.92) days and this difference was statistically significant as p-Value &lt;0.05. Also using Vancouver scar scale to assess the quality of scar, there was statistically significant difference between both (group A) and (group B) as (p-value = &lt;0.001). Among study cases, there were only two cases (7.41%) where complicated by superficial infection, which settled in both halves of each case, was improved on repeated dressing.

Conclusion
The intradermal injection of SVF in donor site resulted in significant reduction in healing time, increased epithelium thickness and a significant improvement in scar quality with low rate of infection.
Evaluation of the Effect of Nanofat Grafting in the Healing Process of Chronic Ulcers
Authors: Saif Eldein Elsayed Sherief Mohamed , Helal Hesham Ali Ahmed , Ghanem Mohamed Abdelmohsen , Labib Jolly Mounir William , Abdelgawad Ebrahim Mohamed Amin 
Published: November 2024

Abstract

Background
Nano-fat is one of the richest sources of adipose-derived stem cells and other progenitor cells. This work aimed to assess Nanofat injection in chronic ulcers and evaluating its healing process.

Methods
This prospective randomized controlled study was carried out on 20 patients aged above 18 years old and less than 60 years old with no co morbidities, both sexes, with chronic ulcers with no healing for at least 3 months with conservative management, small sized ulcers maximum diameter of 5 cm, upper and lower limb traumatic ulcers. Patients were divided in to two equal groups: Group A: Scheduled for Nanofat injection. Group B: No plan for surgical intervention

Results
Collagen formation, re-epithelization, neovascularization, Vascularity, pigmentation, and height were significantly improved in group A than group B. Time frame for complete healing was significantly delayed in group B than group A. The median time for complete healing in Group A was 3 weeks, while in Group B was 16.5 weeks. Satisfaction was significantly increased in group A than group B. skin biopsies showed that epidermal thickness, the area % of elastic fibres and the number of proliferating cell nuclei of the group A were increased compared to the untreated ulcers of group B.

Conclusions
Nano fat grafting may be a promising treatment option for patients with traumatic ulcers, as it can improve wound healing outcomes and patient satisfaction.
Ultrasound-Guided Percutaneous Ethanol Ablation in Cystic and Predominantly Cystic Thyroid Nodules
Authors: Abdrabo Ahmed Abdelhaq Tawfik , Abd EL Hamid Hetta Waleed Mohamed , ElShimy Ahmed Mohamed Samy 
Published: November 2024

Abstract

Background
thyroid cystic and predominantly cystic nodules are frequent among the general population. Some can increase in size with time and cause pressure and cosmetic symptoms. Their standard line of treatment is usually simple aspiration which was found to have high recurrence rate. Recurrent cystic thyroid nodules were considered for surgical removal which had many serious adverse effects.

Aim of the Work
to evaluate the efficacy, and safety of ultrasound guided percutaneous ethanol injection in cystic and predominantly cystic thyroid nodules in patients referred to Interventional Radiology Unit; Ain Shams University Hospitals.

Patients and Methods
The study was conducted at the Interventional Radiology Unit; Radiology Department, Ain Shams University Hospitals and conducted 20 patients with cystic thyroid nodules.

Results
The present study concludes that EA should be considered as the first option for the treatment of pure cysts and predominantly cystic nodules that are not treated with simple aspiration. EA of thyroid cysts having solid component has limited therapeutic effect and may require multiple sessions. Unlike surgery, EA is a safe procedure that is easy to repeat, is inexpensive, can be performed easily on an outpatient basis, and has only transient side effects.

Conclusion
EA should be considered as the first option for the treatment of benign cystic thyroid nodules, especially pure cystic nodules that are not treated with simple aspiration. EA of thyroid cysts having solid component has limited therapeutic effect and may require multiple sessions. Unlike surgery, EA is a safe procedure that is easy to repeat, is inexpensive, can be performed easily on an outpatient basis, and has only transient side effects.
Chronic Hip Pain of Musculoskeletal Origins: Ultrasonographic Evaluation with MRI Correlation
Authors: Ismail Mohsen Gomaa Hassan , Allam Allam El-Sayed , El-Ghamry Saba Ahmed , Youssef Youssef Ahmed 
Published: November 2024

Abstract

Background
Hip pain can be difficult to attribute to one single specific cause, both clinically and radiographically. Yet, there are often subtle signs that point to the nature of the pathology differentiating intra-articular from extra-articular causes of pain.

Aim of the Work
The purpose of this study is to investigate and evaluate the accuracy of sonographic findings compared with magnetic resonance (MR) imaging findings in the diagnosis of different causes of chronic hip pain in adults in order to consider it as an adequate practical alternative when MRI primary assessment is not.

Patients and Methods
This is cross sectional study included 45 patients with chronic hip pain was conducted at Department of Radio-diagnosis, Ain Shams Universities and other private centers.

Result
The study is based on four findings that constitute the undergoing pathologies causing chronic hip pain, and were used as points of comparisons between the two imaging modalities to determine their ability to identify each.

Conclusion
Despite the fact that Ultrasound requires a skilled practitioner, it can be a reliable imaging modality in assessing tendon pathologies and we suggest it should be used not only as a complementary procedure to MR but also an effective alternative.
Role of Magnetic Resonance Elastography in Assessment of Hepatic Focal Lesions
Authors: Abo El Maaty Mohamed El Gharib , Hussein Ahmed Mohamed , Mohamed Hesham Salah , Abd EL Naby Ahmed Ali 
Published: November 2024

Abstract

Background
Hepatic focal lesions have been a common reason for consultation faced by gastroenterologists and hepatologists. It is important to consider not only malignant liver lesions, but also benign solid and cystic liver lesions.

Objective
to evaluate and confirm the role of magnetic resonant elastography in assessment of the hepatic focal lesions and differentiate benign from malignant hepatic focal lesions.

Patients and Methods
This is a cross sectional study included 30 patients with variety of focal lesions identified either by dynamic MRI or by histopathology.

Results
Our study showed that a cut off value of 4 Kpa had a 90% sensitivity, 85.7% specificity, 95% positive predictive value, 75% negative predictive value and accuracy 90 %.

Conclusion
MRE showed a great potential as a promising non invasive technique for quantitative evaluation of hepatic masses that could introduce more data useful in characterization of the focal lesions.