bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Systematic Review of Unilateral Biportal Endoscopic Spinal Surgery versus Uniportal Endoscopic Spinal Surgery in Lumbar Canal Stenosis: Clinical Results and Complications
Authors: Youssef Magdy Gamal Abdelkader , Zaki Mina Sameh , Rafek Omar , Alghazawy Mohamed Foad 
Published: November 2024

Abstract

Background
Lumbar spinal stenosis is an important cause of pain and disability in the aging population. The true prevalence of symptomatic spinal stenosis is unknown because radiographic evidence of the condition does not always lead to clinical symptoms. Boden performed a cross-sectional analysis of MRI findings in a population of asymptomatic individuals and found that 30% to 90% of asymptomatic adults had a major spinal abnormality, including disc herniation, disc degeneration, and spinal stenosis.

Objective
To compare the clinical outcomes and complications of uniportal endoscopic spine decompression versus unilateral biportal endoscopic spine decompression in management of lumbar spinal stenosis.

Methods
This study was Randomized control trials, We included 197 patients from 3 studies; 92 in uniportal group and 105 in biportal. We compared VAS score for back pain and leg pain immediate postoperative and after 12 months.

Results
There was highly statistically significant difference found between the two studied groups regarding operative time (minutes) with p-value &lt;0.003. That there was no statistically significant difference found between the two studied groups regarding complications as dural tears as well as length of hospital stay.

Conclusion
Our study show that Biportal and uniportal endoscopic spine surgery are both safe and effective technique in treating LSS as well as the new Biportal endoscopic technique proves to be superior method to shorten the operation time as well as learning curve. However, more randomized controlled trials with larger sample sizes are needed to strengthen the demonstration of the current conclusions.
Percutaneous Epiphysiodesis Using Transphyseal Screws in Management of Coronal Plane Knee Deformities. A Prospective Case Series
Authors: Gendy Poula Gad Shenouda Gad , Abdelaziz Tarek Hassan , Ghaly Nabil AbdEl-Moneem , Fayyad Tamer Abdelmaguid Mohamed , Elbeshry Shady Samir 
Published: November 2024

Abstract

Background
Although many studies reported the efficacy of using percutaneous epiphsiodesis using transphyseal screws (PETS) in correction of coronal plane knee deformities, a lot of them refrained from using this technique because of lack of objective evidence of its reversibility.

Methods
Twenty-three patient aged from 8 years to 13 years old (40 lower limbs) with coronal plane knee deformity were enrolled into this prospective case series from September 2019 to June 2023. Rate of correction of Mechanical axis deviation MAD, mechanical lateral distal femoral angle mLDFA and medial proximal tibial angle MPTA were measured to prove PETS efficacy. Lower limb length, mLDFA, MPTA were recorded preoperatively and 6 months after screw removal in addition to CT scan of the treated physis to investigate physis behavior and reversibility of the technique.

Results
The mean MAD correction rate was 3.3 mm/month and 1.78 mm/month for genu valgum and genu varum patients respectively. mLDFA mean correction rate was 1.07 degree/month for genu valgum patients while MPTA mean correction rate was 0.81 degree/month for genu varum patient. No physeal bony bars could be detected 6 months after screw removal for all patients.

Conclusion
PETS is a highly effective method of hemiepiphysiodesis with rate of correction faster than the other methods of epiphysiodesis. Moreover, it is reliable, reproducible, easy, cheap, more cosmetic, safe and completely reversible when used in juvenile and early adolescent pediatric population
Assessment of Local Complications with Preoperative versus Postoperative Radiotherapy in Patients with Soft Tissue Sarcoma in Extremities: A Randomized Comparative Clinical Trial
Authors: Abdallah Ziad Khaled , EL Masry Ayman Mohammad , Azmy Sherif Ishak , El Mowafi Mohamed Ahmed , Rahman Mustafa Mohamed Abdel 
Published: November 2024

Abstract

Background
Radiotherapy is considered a cornerstone as adjuvant or neo adjuvant to surgery in extremity soft tissue sarcoma (ESTS). Wound complications are the most agonizing complication that may have an impact on patient’s functional outcome following radiotherapy. The best care for ESTS is by combining extensive surgical excision with safety margin and radiotherapy either preoperative (neoadjuvant) or postoperative. Preoperative radiotherapy allows for lower dose of radiation over smaller fields which is supposed to decrease long-term complications. However, several studies have shown that early complications which include wound dehiscence, infection, seroma and burn may be more frequent with preoperative radiotherapy than with postoperative radiotherapy. Most of these studies were retrospective. This study aims to prospectively assess and compare the early complications associated with radiotherapy in both techniques.

Hypothesis
Preoperative radiotherapy is not inferior to postoperative radiotherapy regarding early wound complications.

Patients and Methods
Between January 2021 and June 2022, we prospectively studied 22 patients and categorized them into two groups, group A (preoperative radiotherapy) and group B (postoperative radiotherapy). We included patients with extremity soft tissue sarcoma in skeletally mature patients who were randomized into two groups with follow up 9 – 12 months. Wound complications, local complications, recurrence, time for wound healing and survival rate were recorded and analysed using SPSS 25.

Results
22 patients were included, 10 in group A and 12 in group B, their mean age was 46.4 years with mean follow up 9 months. The major wound complications were higher in group A (preoperative radiotherapy). in comparison with group B (postoperative radiotherapy), however, this was not statistically significant. While other local complications were higher in group B, it was also statistically insignificant. Time for wound healing was higher in group A more than group B and was statistically significant (p value = 0.011)

Conclusion
No increase in the wound complications rate with preoperative radiotherapy by using low fractionated doses of radiotherapy and increasing interval before surgery to six weeks, although there is increased risk of delayed wound healing time after surgery. The size and site of the tumor may increase the risk of wound complications unrelated to the type of radiotherapy.
The Diagnostic Role of α-smooth Muscle Actin in Superficial Invasive Laryngeal Squamous Cell Carcinoma
Authors: Zanaty Nourhan E , El-Badawy Nafissa M A , Gabal Huda H Abou , Farid Laila M S 
Published: November 2024

Abstract

Background
Diagnosis of superficial invasion of laryngeal squamous cell carcinoma (LSCC) is a major challenge for pathologists as its confirmation is mainly based on histomorphologic features especially in presence of differentials and in absence of reliable diagnostic immunohistochemical markers. Despite focusing on study of tumor cells, the study of tumor microenvironment (TME) and its major component cancer associated fibroblasts (CAFs) will help to understand the participation of the tumor stroma in tumor development, progression and invasion differentiating it from other premalignant and benign lesions whose features may overlap with superficial invasive LSCC causing diagnostic dilemma. CAFs are characterized by the expression of α-smooth muscle actin protein (α-SMA) which represents the major component used to detect mesenchymal cells during process of TME.

Objective
To assess the diagnostic role of α-smooth muscle actin immunohistochemical expression in superficially invasive laryngeal squamous cell carcinoma.

Methods
The current study was conducted retrospectively on 108 cases of laryngeal biopsy samples as archived formalin fixed paraffin embedded blocks obtained from the Pathology Department lab of Ain Shams University Hospitals (Jan 2020-Dec 2022). The cases included in the current study were divided into 4 groups; Group 1: included 32 superficial invasive LSCC cases, Group 2: included 20 Laryngeal HGD/SIL cases, Group 3: included 36 PEH cases and Group 4: included 20 invasive LSCC cases. Data concerned with gender, age, lesion laterality, site and smoking history were obtained from the electronically archived reports. The histopathological data were re-examined microscopically by at least two authors. After then, the expression of Alpha SMA was evaluated in different groups, followed by statistical evaluation of the obtained results.

Results
Immunoreactivity of α-SMA was expressed in 87.5% of superficial invasive LSCC cases and 100% of invasive LSCC cases, while no reactivity was observed in all cases of HGD/SIL group, and rarely in PEH group (5.6%). There was statistically significant correlation between alpha SMA and both stroma changes and percentage of TILs in stroma of superficial invasive LSCC and no statistically significant relationship between alpha SMA expression and age, sex, lesion’s laterality, site, microscopic growth pattern, smoking, koiliocytic changes and hyperkeratosis in superficial invasive LSCC cases. The α-SMA expression pattern in stroma of superficial invasive LSCC was significantly different from that of HGD/SIL and PEH groups.

Conclusion
Alpha SMA is a potentially valuable marker for labelling CAFs and plays a reliable ancillary role in confirming the invasion for superficial invasive LSCC and differentiating it from HGD/SILs and PEH cases.
Transvesicoscopic Cohen Ureteric Reimplantation for Vesicoureteral Reflux in Children: A Pilot Study
Authors: Hegazy Amr T , Allam Ayman M , Dahab Mohamed M , Radwan Ahmed B , Badawy Haitham E , Hassan Tarek A 
Published: November 2024

Abstract

Background
Cohen’s pneumovesicoscopic reimplantation technique (CPRT) is a minimally invasive procedure that resembles the surgical steps of the open cross-trigonal reimplantation technique with a similar success rate and the inherent benefits of a minimally invasive approach, like less need for analgesia and less morbidity.

Aim of the Work
to evaluate the efficacy and safety of CPRT in 20 pediatric patients with primary VUR presented to 2 pediatric surgery departments, in 2 tertiary centers.

Patients and Methods
a prospective interventional study on 20 children (13 girls, 7 boys, age ranged from 4 to 12 years) with primary vesicoureteral reflux (VUR), grades II-IV (6 bilateral, 9 RT and 5 LT) underwent a CPRT. Suprapubic ports were placed: a 5-mm camera port and two 3- mm working ports. After the ureter(s) have been dissected transvesically a submucosal tunnel is made for ureteric reimplantation to be carried out using 5/0 absorbable sutures. After the procedure, the urethral catheter was taken out two days later, and the patients were released on day three. Clinical evaluation, renal ultrasonography, and voiding cystourethrogram were used to Follow-up the patients.

Results
198.5 min was the average operating time (range 90 – 240 min). Two cases developed postoperative complications (mild suprapubic emphysema-perivesical hematoma) managed conservatively. One case needed conversion to open technique because of intraoperative complications (port displacement- perivesical air leakage). All patients had renal US and VCUG between 3 and 6 months after surgery. All low-grade reflux patients (grade II & III) had their hydronephrosis disappear on postoperative US (13 out of 26 refluxing units), while persistence of grade I VUR on VCUG was in two cases (2 units).

Conclusion
Technically feasible, Cohen’s pneumovesicoscopic reimplantation technique can be carried out safely and effectively in children. It is advisable to select the patients carefully in the primary phase of this technique. Some technical modifications are suggested to overcome the technical obstacles faced, helping us to master this promising technique.
Outcome of Peri-Anal Injury Management in Children and Adolescents
Authors: Muhammad Fahmy Mahmoud Ahmad , El- Sayyed Morad Ahmed , Arafa Ahmed Bassiouny , Girgis Nader Nassef 
Published: November 2024

Abstract

Background
Accidental genital trauma and perineal injury are relatively uncommon in the paediatric population and are often related to accidental falls, motor vehicle crashes and sexual abuse. Blunt perineal trauma causes mechanical compression of the soft tissues against the pelvic bones. Management of perineal injury differs depending on the mechanism of injury and the presence of additional trauma. The severity and extent of injury are often difficult to estimate by only physical examination, and radiological modalities may be insufficient to determine the true extent of damage in severe cases. In such cases, a diagnostic endoscopic examination under anesthesia is useful to fully comprehend the damage.

Objectives
To evaluate and describe outcome of different perineal trauma mechanisms and management in pediatric patients.

Methods
Retrospective descriptive analytic study of outcome of perineal injuries management, was conducted on 11 patients aged under 18 years old with perineal injuries due to perineal trauma, admitted to pediatric surgery department or followed up in colo-rectal clinic of pediatric surgery department, Faculty of Medicine, Ain Shams University Hospitals.

Results
Three patients with isolated genital injury or perineal body injury could be primarily repaired without fecal diversion, one case developed wound dehiscence due to stool contamination so fecal diversion was done. The other seven patients with involvement of ano- rectum underwent fecal diversion from the start, with four cases had their wounds primarily repaired, two cases left to heal by 2ry intention and underwent definitive perineal reconstruction later on, and only one case of impalement that had no any external wounds.

Conclusion
Perineal injury management should start with resuscitation, thorough examination, proctoscopy, vaginoscopy or cystoscopy could be needed, examination under anesthesia is a gold standard measurement. Patients with isolated genital injuries could be primarily repaired without fecal diversion. Patients with ano-rectal involvement mostly will need fecal diversion, with primary repair of the perineal wounds or leaving it to heal with 2ry intention according to the degree of contamination, time of presentation, degree of ano-rectal involvement. Perineal body reconstruction technique based on the principles of the PSARP operation used in ano-rectal malformations.
A Comparative Study between Honey and Alcohol as Topical Skin Disinfectant
Authors: Mohamed Abdul Rhman Mamdouh Abdul Maksoud , Awad Yosra Mohamed Mohsen , Anwar Hafez Maha Ahmad , Mansour Ahmed Badr Nouh 
Published: November 2024

Abstract

Background
Skin antisepsis is essential in every healthcare environment. Alcohol/ chlorhexidine use might disrupt skin microbiota and lead to antibiotic resistance.

Objective
To evaluate the efficacy of honey on reduction of skin microbes, on apparently healthy skin, and to compare the results with those of topical application of 70% isopropyl alcohol.

Subjects and Methods
This study was carried out on 70 children aged 2 to 12 years. Males represented 54.2% of the sample. Patients were recruited from the pediatric outpatient clinic, Children’s Hospital, Ain Shams University, Egypt, during the period from July 2022 to February 2023. A swab was taken from the skin of the dorsum of both hands for culture of skin microbes. Types and number of organisms were documented. Separately, honey and alcohol were applied alternatively on the dorsum of right and left hands. A skin swab was taken for microbiological examination before and 20 seconds after application of honey and alcohol.

Results
mean age of enrolled children is 7.34 (in years). Both honey and alcohol made significant reduction in the number of organisms on the dorsum of the hand (p = &lt;0.001), and this effect was comparable between honey and alcohol with no statistically significant difference (p = 0.874). Before honey application, the median number of organisms is 65 colony forming unit (CFU), while 10 (CFU) is the median number of orgamisms after honey application. Before alcohol application, the median number of organisms is 80 (CFU), while 10 (CFU) is the median number of organisms after alcohol application. Percentage of reduction of organisms on dorsum of the hand after honey application is 62.5%, while 65% after alcohol application (p = 0.370). Staph coagulase negative, staph aureus, E-coli are most three common organisms were detected by swab.

Conclusion
Honey showed to be as effective as alcohol in reduction of skin microbes. We recommend further studies involving following up the rate of infection after minor surgical procedures to confirm the findings of our study.
Evaluation of Plasma D-Lactate Level in Preterm Infants in Necrotizing Enterocolitis
Authors: Farid Ahmed Hamdy , Metwally Mohamed Hussein , Alfattah Dina Tharwat Abd , EL-Deen Ola Galal Badr 
Published: November 2024

Abstract

Background
Necrotizing enterocolitis (NEC) is a severe and potentially lethal intestinal disease that occurs almost exclusively in preterm infants. Currently, the diagnosis of NEC is based on clinical and radiographic findings. Utilization of non-invasive biomarkers for early diagnosis is the preferred attitude in most of the diseases.

Aim of the Work
Measure plasma D-lactate levels in preterm infants diagnosed with NEC in comparison to age-matched controls and also to correlate these levels to severity of intestinal ischemia in these cases.

Patients and Methods
The current study included 30 preterm neonates diagnosed with NEC and 30 preterm neonates who were admitted into NICU (Neonatal intensive care unit) due to other cause rather than NEC (as a control group)., All the cases underwent full history taking, full general examination and full local regional examination(measurement of abdominal girth, intestinal sounds, passage of stool, gastric residual, abdominal tenderness). The laboratory (Hemoglobin level, platlets count, white blood cells count, plasma D-lactate level) and the radiological investigations (Abdominal erect xray) were also conducted. Lactate level was measured at two occasions (on admission and after one week) The cases were followed up to determine the outcome (the mortality).

Results
The D-lactate level (at first sample at onset NEC) in the NEC group was statistically significantly higher as compared to the control group (p &lt; 0.001); median (IQR) : 7.11 (6.79 – 11.82) versus 4.11 (1.99 – 4.96)]. The level of plasma D lactate showed a statistically significant decrease between first and second sample(After one week) in discharged patients with no statistically significant change in died patients. The best cutoff point of D-lactatein the first reading to identify cases with NEC was &gt; 5.45 mmol/L with diagnostic sensitivity 100%, specificity 100% and accuracy 100%.

Conclusion
The use of plasma D-lactate levels as a marker of intestinal injury could be useful as a diagnostic indicator in the early stage of NEC. Moreover, d-lactate can be correlated with the severity of NEC.
Neuropathic Pain and Clinical Sensory Testing in Young Patients with Sickle Cell Disease
Authors: Adly Amira Abdel-Moneim , Makkeyah Sara Mostafa Mohammad , Mohammed Maha Zakariya Ramadan , Wassif Ghada Ossama Mohamed , Nassef Marwa Abdelaziz , Aboata Ahmed Mostafa Ahmed 
Published: November 2024

Abstract

Background
The pathophysiology of pain in sickle cell disease (SCD) is complex and not fully understood. Neuropathic pain (NP) is an emerging theory of chronic pain in SCD. Nevertheless, assessment of NP is not a part of standard care of patients with SCD.

Aim and Objectives
To study the frequency of neuropathic pain among young patients with SCD by ID-P questionnaire and Clinical Sensory Testing (CST).

Patients and Methods
In this cross-sectional study Patients with SCD were recruited and data were collected on sociodemographic and clinical criteria of the disease. ID Pain (ID-P) questionnaire was used as a screening tool for NP. We performed a bedside clinical sensory testing (CST) including cold, warm, and pressure detection, cold, heat, mechanical and pressure pain threshold.

Results
Fifty-six participants were screened for eligibility and twelve of them were excluded; ten had stroke and two patients were diabetic. A total of 44 participants (25 males and 19 females) were included, their mean age was 12.4 years (SD 4.8; range 5.9-25 years). Screening of NP using the ID-P questionnaire revealed that 22.7% of the study cohort likely had NP. On the other hand, 34% of the participants had abnormal CST; 10 patients (22.7%) had abnormal mechanical pain threshold, 6 (13.6%) showed abnormal cold pain threshold, 2 (4.5%) had abnormal heat pain threshold and 2 (4.5%) with abnormal pressure threshold, while only one patient had delayed cold detection.

Conclusion
Neuropathic pain, as assessed by ID-P questionnaire and CST, is not uncommon in young patients with SCD.
Serum Levels of the Systemic and Brain-Specific Antibodies in Autistic Children
Authors: Mostafa Gehan Ahmed , Mehrez Amany Beniameen Ahmed , Shousha Ghada Abdel Haleem , Shehab Abeer Al Sayed , Youssef Azza Mohamed 
Published: November 2024

Abstract

Background
Some autistic children may have an imbalance of the T-helper (Th)1/Th2 lymphocytes toward Th2. Th2 cells are responsible for the allergic response and the production of antibodies.

Aim
We were motivated to investigate the frequency of the brain specific antibodies anti- myelin oligodendrocyte glycoprotein and anti-myelin associated glycoprotein (anti-MoG) and systemic antibodies Anti-Nuclear Antibody (ANA) in the serum of a group of Egyptian autistic children.

Patients and Methods
This pilot case-control study was conducted at the Department of Pediatrics, Children's Hospital, Faculty of Medicine, Ain Shams University over a period of 6 months, from May 2022 to November 2022. Twenty five autistic children aged 4 to 16 years and twenty five age- and sex-matched healthy children were included after excluding children with any chronic, allergic or autoimmune disease. Diagnosis of autism was settled according to 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Serum levels of brain specific antibodies (anti-MoG) and systemic antibodies (ANA) were assessed for the patients and healthy children using Enzyme-linked immunosorbent assay (ELISA) technique.

Results
Male to female ratio was 3.17:1. Family history of Autism spectrum disorder (ASD) was positive in 2 patients. True seizures were detected in 3/25 (12%) of the studied children. Mild ASD was found among 64% and severe illness was detected among the other 36% of the studied patients using Childhood Autism Rating Scale (CARS). According to anti-ANA 23 healthy control children had negative ANA and the other two had positive ANA. However 23 autistic children had negative ANA and two had borderline level. Anti-ANA not detected among autistic children. According to Anti-MOG 25 healthy control children had negative anti-MOG. However 24 autistic children had negative anti-MOG and one had positive anti- MOG. P-Value of anti-MOG was 1.00 and P-Value of anti-ANA was 0.135.

Conclusion
Specific brain antibodies, anti-MOG, and systemic antibodies, ANA were not detected in higher levels among autistic children compared to healthy control. The study was limited by the small sample size. ASD patients and healthy children showed comparable serum levels of ANA. One autistic child had positive anti-MOG. Compared to healthy control group, the difference of results of brain antibodies was statistically non-significant.