bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Efficacy and Safety of Combined Extracorporeal Shock-Wave Therapy (ESWT) with Phytotherapy versus ESWT Alone in Chronic Prostatitis Category IIIB
Authors: Yaseen Mohammed Mohammed , Mousa Waleed Elsayed , Sadeq Mohammed Metwally , Georgui Elias Mina Atef , Mohammad Ebraheem Rashed Mostafa Mohammad , Ahmed Abdullah Mohamed Abdelmonem 
Published: November 2024

Abstract

Background
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the four categories of chronic prostatitis. It is a prevalent and poorly understood disease. The widespread presence of CPPS is over 90–95% among all the four categories of prostatitis.

Objective
To compare the efficacy and safety of ESWT combined with Phytotherapy and ESWT alone in treatment of chronic prostatitis category IIIB.

Patients and Methods
This prospective comparative clinical study (double armed) included 30 patients with clinical diagnosis of CP/CPPS were enrolled in the study. The patients were randomly allocated to either the ESWT plus Phytotherapy group (group A; n = 15) or the ESWT only group (group B; n = 15). A total of eight ESWT treatment sessions, once weekly were administered alone or in combination with Phytotherapy. Each session consisted of 3,000 shock waves. Phytotherapy that contains powder extract of (saw palmetto, tomato, uva ursi, pygeum, pumpkin) 1 capsule twice daily for 8 weeks. The changes in urinary symptoms, pain and quality of life were considered the main outcome measures and were assessed at baseline, after 4 and 8 weeks from the start of treatment, and 2 and 4 months after the end of treatment by National Institutes of Health-developed Chronic Prostatitis Symptom Index (NIH-CPSI).

Results
When we compared both groups of patients at the end of the study as regards Pain, Urination, Qol, and total score of NIH-CPSI, we find a significant improvement in both groups equally, as Independent t-test and Mann-Whitney test showed no significant difference between group A and group B (p &gt; 0.05).

Conclusion
The study shows that ESWT is an effective and safe treatment modality for CP/CPPS, whether combined with Phytotherapy or not.
Transurethral Intraprostatic Injection of Botulinum Toxin Type A for the Treatment of Category III Chronic Prostatitis: A Randomized Sham Controlled Study
Authors: Osman El-Sayed Tarek , Shabayek Mohamed Ismail , Sadek Ahmed Tarek Mohamed 
Published: November 2024

Abstract

Background
Chronic non-bacterial prostatitis (CNBP) is a common disease associated with pain, urinary and sexual symptoms. Diagnosis and treatment of CNBP is usually difficult and requires multiple approaches and usually with unsatisfactory outcomes.

Aim and Objectives
to assess the effectiveness of the intraprostatic Botulinum toxin type A (BONT-A) in the treatment of refractory CNBP in a randomized sham-controlled trial.

Subject and Methods
70 patients with refractory CNBP were equally randomized into two groups. Patients in treatment group (group 1) received transurethral intraprostatic BONT-A injection, whereas patients in sham group (group 2) received transurethral intraprostatic saline injection. Baseline national institute of health chronic prostatitis symptom index (NIHCPSI) was evaluated before intervention and reassessed after 1, 3 and 6 months following treatment.

Result
Age, prostate size, duration of symptoms as well as baseline total NIHCPSI were not statistically significantly different between both groups before intervention (30.29 vs. 29.8 for group 1 vs. group 2 respectively, p = 0.583). We found statistically significantly reduction of NIHCPSI total score in group 1 compared to group 2 at all intervals of follow up (27.21 vs. 29.03, p = 0.037, 24.97 vs. 28.59, p &lt; 0.001 and 21.76 vs. 27.27, p &lt; 0.001, at 1, 3 and 6 months respectively). Mean pain subscale scores statistically significantly decreased in group 1 compared to group 2 from baseline (14.77 and 14.06 for group 1 and group 2 respectively, p = 0.127) to 12.52 and 13.79, p = 0.010, 11.53 and. 13.25 p &lt; 0.001 and 10 and 13.33, p &lt; 0.001 after 1, 3 and 6 months respectively. Similarly, mean quality of life score statistically significantly improved in group 1 compared to group 2 from baseline (7.74 and. 8.40 for group 1 and. group 2 respectively, p = 0.038), then after 1, 3 and 6 months (6.09 vs. 7.88, p &lt; 0.001, 5.56 vs. 7.81, p &lt; 0.001 and 4.74 vs. 7.39, p &lt; 0.001 respectively). Mean urinary symptoms scores statistically significantly decreased in group 1 compared to group 2 at all follow up intervals from baseline (7.77 and. 7.34 for group 1 and group 2 respectively, p = 0.136), to 6.15 vs. 7.06, p &lt; 0.001, 5.75 vs. 6.97, p &lt; 0.001, 4.91 vs. 6.58 p &lt; 0.001 after 1, 3 and 6 months respectively. Maximal effect of treatment with BONT-A was at 6 months. Mild dysuria and hematuria were the only two postoperative complications encountered after intervention in both groups.

Conclusion
Transurethral intraprostatic injection of BONT-A is a safe and effective treatment for refractory CNBP.
Efficacy of Ultrasound-Guided Renal Access for Percutaneous Nephrolithotomy in Combination with Fluoroscopy versus Fluoroscopy as a Single Imaging Modality
Authors: Gad Hany Hamed , El-Baz Ahmed Gamal El-Din , Badawy Mohammed Hussein , El-Saeed Mohamed Hassan , Rashed Kareem Ayman 
Published: November 2024

Abstract

Background
Renal stone is one of the most common renal diseases worldwide. There are several modalities for treatment of renal stone disease, one of these modalities is the use of percutaneous nephrolithatomy (PCNL) surgery which can be done either under fluoroscopic or ultrasound guidance which has significantly reduced x-ray exposure risk to medical personnel and patients.

Objective
To evaluate the efficacy of the ultrasound-guided PCNL in combination with fluoroscopy to minimize exposure time to radiation, risk of accidental injury to adjacent organs, blood loss and increased stone clearance rate versus usage of fluoroscopy as a single imaging modality in PCNL.

Patients and Methods
This prospective randomized comparative clinical trial study was conducted on 40 patients for the treatment of stone(s) located in the kidney more than 2 cm or refractory to shockwave therapy, patients were divided into 2 groups, 20 patients each; Group I: ultrasound-guided PCNL in combination with fluoroscopy and Group II: use of fluoroscopy as a single imaging modality, the study was carried on at Urology department, Faculty of medicine, Ain Shams University and Urology department, Theodor Bilharz Research Institute.

Results
As regard post operative complications in studied groups, in group I, there were 3 patients (15%) with post-operative fever versus 4 patients (20%) in group II. In group I, there was 1 patient (5%) with post-operative leakage versus 3 patients (15%) in group II. In group II, there was 1 patient (5%) with post-operative blood transfusion versus 0 patients (0%) in group I with no statistical difference. With respect to post-operative hospital stay and need for second operation between studied groups, there was a highly statistical significant (p-value &lt; 0.001) increased post- operative hospital stay in group II (3.5 ± 1.05) when compared with group I (1.9 ± 0.9). While, as regard need for second operation and type of the operation, there were no statistical differences between the studied groups. But, there was high statistical significant difference (p-value &lt; 0.001) decreased x-ray exposure time in group I (43.2 ± 11.3 sec) when compared to group II (314 ± 84.2 sec).

Conclusion
Combined ultrasonic and fluoroscopic guided PCNL had shorter x-ray exposure time. Combined ultrasonic and fluoroscopic guided PCNL had less Hb drop and intraoperative complications. However it still had longer surgery duration. Combined ultrasonic and fluoroscopic guided PCNL showed less postoperative pain and analgesic consumption. Combined ultrasonic and fluoroscopic guided PCNL had shorter hospital stay. Regarding the outcome and complications, in general, there is no statistical significant difference between these two groups.
Efficacy of Tamsulosin plus Tadalafil versus Tamsulosin as Medical Expulsive Therapy for Lower Ureteric Stones in Egyptian Population
Authors: Fathy Zaher Mohamed Tarek Mohamed , Mohamed Mohamed Saeed Salim , Khella Kirillos Raafat Nashed 
Published: November 2024

Abstract

Background
Urolithiasis is one of the most common disorders of the urinary tract with life-time prevalence of up to 15% with men affected three times more than women.

Aim of the Work
To assess the efficacy of Tamsulosin plus Tadalafil as medical expulsive therapy (MET) in comparison to tamsulosin monotherapy for the treatment of lower ureteric stones with renal colic.

Patients and Methods
This Randomized Clinical Trial was conducted in the Urology Department, Ain Shams University Hospitals and Kobry El-Kobba Military Hospital. This study was conducted on 80 patients within the whole experiment. Participants were divided into two groups through random computer-generated numbers; Group A was treated with tamsulosin plus tadalafil, and Group B was treated with tamsulosin only.

Results
The current study showed mean expulsion time in Group A ranged from 1 to 2 week with mean ± SD = 1.72 ± 0.45 while in Group B the mean expulsion time ranged from 2 to 3 week with mean ± SD = 2.28 ± 0.45 with highly statistically significant difference (p = &lt;.001) between the two groups. We showed there was a statistical significant difference between the two groups regarding mean no. of colic episodes and emergency visits among the studied groups.

Conclusion
We assess the efficacy of Tamsulosin plus Tadalafil as medical expulsive therapy (MET) in comparison to Tamsulosin monotherapy for the treatment of lower ureteric stones with renal colic. The addition of tadalafil with tamsulosin increases ureteric stone expulsion quite significantly along with significant control of pain, significantly less analgesic requirement and fewer hospital visits.
Impact of Hyperuricemia on Left Ventircular Function in Hypertensive Patients Presented to Ain Shams University Hospitals
Authors: Zahraa Mostafa Fatma El , El Sayed Abd El Rahman , Galal Haitham 
Published: November 2024

Abstract

Background
The association between serum uric acid and cardiovascular diseases has long been recognized. Aim: The aim of study was to assess the left ventircular function in hypertensive patients with or without hyperuricemia.

Patients and Methods
This prospective, comparative, cross sectional study involved 300 patients coming to cardiology clinic for clinical assessment. The study was performed in the cardiology department, faculty of medicine, Ain Shams university hospital at the period from july 2022 to march 2023.

Results
The results of the study show a significant difference in the tie index among the three groups (Hypertension with Hyperuricemia, Hypertension without Hyperuricemia, and Control). The median tie index was highest in the Hypertension with Hyperuricemia group (0.46) followed by the Hypertension without Hyperuricemia group (0.42) and was lowest in the control group (0.37). The difference in tie index between the groups was statistically significant with a p-value of &lt;.001.

Conclusion
This study reveals that hyperuricemia is widespread in our study population with systemic hypertension and both are positively correlated. Hyperuricemia was associated with LVH. Thus, the study recommends a repetitive evaluation of serum UA in all hypertensive patients. As it suggests that hyperuricemia is an early marker of increased left ventricular mass that can be used to identify a hypertensive population with cardiac TOD.
Impact of Angiotensin Receptor-Neprilysin Inhibitor Therapy on Cardiac Remodeling in Patients with Heart Failure and Reduced Ejection Fraction
Authors: Sadek Mahmoud Hazem , Aboul-Saud Mona Ibrahim , Missiri Ahmad El , El-Din Yasser Alaa 
Published: November 2024

Abstract

Background
Structural alterations in cardiac structures in response to hemodynamic and neurohormonal factors are the main drivers of heart failure progression. In the combination ARNI, molecular synergy may reverse or reduce left ventricular remodeling. Speckle-tracking echocardiography (STE) is an established echocardiographic modality with clinical applications in the diagnosis and prognosis of many cardiac diseases.

Aim of the Study
The study was done to evaluate the possible impact of Angiotensin Receptor-Neprilysin Inhibitor (ARNI) therapy on cardiac remodeling using echocardiographic parameters including 2D and 3D global longitudinal strain (GLS) in heart failure patients with reduced ejection fraction

Patients and Methods
This prospective observational study included a total of eighty heart failure patients were divided into two arms. The first arm included forty symptomatic patients started on ARNI and the second arm was forty symptomatic patients on an optimal dose of ACE-I or ARBs, receiving standard treatment of heart failure and who were followed up for six months. All patients underwent echocardiography to assess baseline values including indexed LV volumes, 2D STE and 3D STE before initiating ARNI therapy and after a 6 month follow up period.

Results
Both groups had no significant differences at baseline regarding demographic data and baseline echocardiographic findings, After 6 months follow up period, significant reduction in LV indexed volumes in ARNI group compared to ACE-I/ ARB group (P &lt; 0.001), improvement in LVEF ARNI group compared to ACE-I/ ARB (P = 0.011), 2D LV GLS ARNI compared to ACE-I/ ARB (P &lt; 0.001) and no improvement in LV mass index. Significant reduction in LAVi ARNI compared to ACE-I/ ARB (P = 0.013), significant reduction in E/A ARNI compared to E/A ACE-I/ ARB (P = 0.043) and no improvement in lateral E/e’.

Conclusion
The use of ARNI for HF patients with reduced LV systolic function, followed up for a mean duration of 6 months, induced LV reverse remodeling in those patients as observed in a significant improvement in LV performance seen in both 2D-3D volumetric echocardiographic parameters, improved LVEF and longitudinal LV systolic function represented in 2D and 3D GLS.
Role of Preprocedural Multi Detector Computed Tomography Angiography in Prediction of Complexity & Outcome of Coronary Chronic Total Occlusion Percutaneous Coronary Intervention
Authors: Mostafa Manar , Darahim Khalid , Onsy Ahmed , Gamal Sahar , Farouk Mohamed 
Published: November 2024

Abstract

Background
Chronic Coronary Total Occlusion (CTO) is considered one of the most challenging obstructive coronary artery diseases that had been widely managed medically or referred for bypass surgeries due to their complex nature which remained an obstacle for the operators. Coronary CT- angiography was used to develop easy predictive tools for CTO percutaneous intervention.

Objectives
To evaluate the ability of the CCTA and CT-RECTOR score to predict time-efficient guidewire (GW) crossing through a chronic total occlusion.

Patients and Methods
The present study included 40 patients with CTO lesions. All were subjected to preoperative CTO assessment using CCTA and CCA before an attempt of PCI to a CTO in the period between January 2022 and May 2023. The study was held in Ain Shams University hospitals and National Heart Institute.

Results
We divided the patients into two groups according to GW crossing within 30 minutes. Group 1 included patients with successful GW crossing within 30 min, group 2 included patients with failed GW crossing within 30 min. We compared the two groups according to demographic data and we found that males are more common to have CTO lesions (87.5%) which were predominantly located in RCA (50% of total no. with 76.9% of them in failed group, p = 0.018). Our results showed that CTOs with occlusion length ≥ 20 mm or calcification increased in failed group, but was not statistically significant (84.6% in failed group (p = 0.161) and 46.3% in failed group (p = 0.432) respectively). In addition, there was a statistical significance between presence of blunt stump (76.9% in failed group vs 29.6% in successful group, p = 0.004), a previous failed CTO-PCI attempt (53.8% in failed group vs 14.8% in successful group p = 0.009), and using retrograde wiring techniques (p = 0.003) between the successful and failed groups. Indicating that these points were important predictors of procedural failure. We compared CTO characteristics between CCTA-derived CT-RECTOR score and CA-derived J-CTO score. with increased score points, the probability of PCI difficulty and GW crossing failure increased. CT-RECTOR score was found to have the better ability for prediction of GW crossing within 30 min and CTO-PCI difficulty (p = 0.028).

Conclusion
CT-RECTOR score was superior to J-CTO score in the assessment and prediction of GW crossing difficulty within 30 minutes and final procedural outcomes.
Correlation between Epicardial Adipose Tissue and the Occurrence of Acute Coronary Syndrome Using 2D Transthoracic Echocardiography
Authors: Leon Ramez Khaled , Baraka Mahmoud Mohamed , Esmail Yasmin Abdel Razek , Guindy Ramez Raouf 
Published: November 2024

Abstract

Aims and Objective
The aim of this thesis is to study the correlation between epicardial adipose tissue, as it’s measured by 2D echocardiography and the occurrence of acute coronary syndrome in the Egyptian population.

Patients and Methods
The study included 100 patients, all of which were presenting with chest pain and underwent coronary angiography followed by 2D echocardiography. The population was then subdivided according to angiographic findings; 50 Patients who had an angiographically significant stenosis over 50% and consequently underwent PCI, and 50 age-matched patients with their coronary angiography showing normal coronaries, as the control group.

Results
Our study has shown that epicardial adipose tissue was thicker in individuals presenting with acute coronary syndrome in comparison to the controls group. We also found that EAT showed a statistically significant and directly proportional relationship with HbA1C, RBS, weight, BMI (in the form of increasing weight and/or decreasing height) and TG.

Conclusion
Our study has revealed that measuring the thickness of EAT using 2D echocardiography showed that EAT was thicker in the patients group presenting with ACS than in the control group, with a cut- off value of 6.6mm. This non-invasive method could have the potential for predicting the occurrence of acute coronary syndrome.
Type 2 Myocardial Infarction; Patients Characteristics & Clinical Outcomes
Authors: Sharaf Sherif , Tamara Ahmed , Elbarbary Ahmed , Hasanein Adel , Ibrahim Mostafa 
Published: November 2024

Abstract

Background
Type 2 myocardial infarction are emerging concepts suspected of being common in emergency departments (ED). However, their respective frequencies, risk profiles, and short-term prognoses remain to be investigated

Objective
To assess prevalence and differences in clinical features, current treatment strategies. and outcome in patients with type 2 versus type 1 acute myocardial infarction

Methods
This Cross sectional prospective study was conducted on 350 Egyptian patients presented in a setting of myocardial infarction allocated to two groups; type I MI and type II MI based on their diagnostic criteria. All patients were recruited from Ain Shams University hospital, Misr University for science and technology hospital during a period of one year [from February 2022 to February 2023 then patients were followed regarding prevalence, patient characteristics, in hospital management and clinical outcomes especially mortality (in-hospital, 30 days and 6. months), MACE and heart failure hospitalization]

Results
The mean age of the studied cases was 56.35 ± 9.52 years, males represented 56.3% of cases, there were 54.9% of the studied cases smokers, 23.1% had a history of IHD, 20% with history of CHF, and 38.3% had a positive family history of heart disease. DM was present in 45.4% of cases while HTN was present in 75.1% of cases. Regarding the type of MI, most of the studied patients had type I (74.9%) and 25.1% had type II MI. There was a significant higher length of stay in type II (median 12 days compared to 5 days) in type I and occurrence of death (13.6% Vs 5.7%) in type I and stroke at 6 months also was significantly higher in type II (3.4% Vs 0.4%) in type I but at 1 month MACE didn’t differ significantly
Conclusions: Type I myocardial infarction is more prevalent than type II, however type II MI is associated with higher mortality rates and longer duration of hospital admissions. The clinical presentation differs between both types where type I MI patients present with chest pain, type II patients present mainly with dyspnea, syncope and dynamic instability. Also, the management plan. differs significantly showing that cardiac intervention is mainly directed for type I MI patients
A Comparative Study between Surgical Cut Down and Percutaneous Closure Devices in Management of Large Bore Arterial Access Used in Structural Heart and Endovascular Interventional Procedures
Authors: Samir Wafed , Tantawy Mahmoud Ahmed , Tamara Ahmed Fathy , El Zahwy Sherif Samir , Mousa Mohamed Ali 
Published: November 2024

Abstract

Background
Compared to conventional open surgery, minimally invasive catheter-based procedures including transcatheter aortic valve implantation (TAVI) and endovascular aneurysm repair (EVAR) have less post procedural complications. TAVI and EVAR require large bore arterial access. Optimal site management of large bore arterial access is pivotal to reduce the hospital- acquired complications associated with large bore arterial access. We wanted to compare surgical cutdown versus percutaneous closure devices in site management of large bore arterial access.

Methods
Participants planned for TAVI or EVAR with large bore arterial access more than 10 French were included, while participants with history of bypass surgery, malignancies, thrombophilia, or sepsis were excluded. A consecutive sample of 100 participants (mean age 74.66 ± 2.65 years, 61% males) was selected, underwent TAVI or EVAR with surgical cutdown (group 1) versus TAVI or EVAR with ProglideTM percutaneous closure device (group 2).

Results
The incidence rate of hematoma was significantly lower in group 2 versus group 1 (p = 0.014), the mean procedure time (minutes) and the median hospital stay (days) were significantly higher in group 1 versus group 2 (t(98) = − 2.631, p = 0.01, and U = 2.403, p = 0.018, respectively), the hemoglobin drop and number of packed red blood cells required for transfusion were significantly higher in group 1 vs group 2 (1.35 ± 0.53 gm/dl vs 1.15 ± 0.29 gm/dl, t(98) = 2.403, P = 0.018 and 0.12 ± 0.33 vs 0.06 ± 0.99, t(98) = 2.975, P = 0.004, respectively), and the c-reactive protein pre- procedure and the c-reactive protein post-procedure were significantly lower in group 2 versus group 1 (U = -2.969, p = 0.003, and U=-2.674, p = 0.007, respectively).

Conclusions
Our study showed a lower incidence rate of large bore arterial access complications as hematoma, a shorter procedure time, a shorter hospital stay, lower hemoglobin drop, and fewer packed RBCs required for transfusion with percutaneous closure devices compared to surgical cutdown.