bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stent Retriever versus Contact Aspiration in Management of Acute Ischemic Stroke; Egyptian Experience
Authors: Amin Aref Hany Mohammed , Elbassiouny Ahmed Ali Ibrahim , Mohammed Hossam Shokri , El-Sudany Ayman Hassan Othman , Abushady Eman Mones Mahmoud , Abd El Monem Eslam Ali Hamed 
Published: November 2024

Abstract

Background
Mechanical thrombectomy (MT) has become the standard treatment in patients suffering from acute ischemic stroke (AIS) due to large vessel occlusion (LVO). It can be classified into thrombo-aspiration, stent-retrieval, and aspiration-retriever combined technique. The evidence on the optimal therapy with acceptable outcomes of safety and efficacy is still limited. Therefore, we conducted this study to compare between stent retriever versus aspiration techniques in MT regarding procedural safety and incidence of complications.

Methods
This prospective cohort study was conducted at Ain Shams University Hospitals, Egypt. One hundred patients admitted to stroke unit with anterior circulation AIS who met inclusion criteria for MT were recruited over three years from March 2020 to March 2023. The included patients were divided into two groups: group one included 50 patients treated with stent retriever and group two included 50 patients treated with contact aspiration thrombectomy.

Results
The median (IQR) for age was 64 (52.5 – 71.5) years. 53 (53%) were males and 47 (47%) were females. No significant difference was found between the compared techniques regarding procedure time (p-value=0.551), time to recanalization (p-value=0.090), thrombolysis in cerebral infarction score (TICI) (p-value=0.461.

Conclusion
Among patients with ischemic stroke in anterior circulation undergoing MT, contact aspiration and stent retriever were comparable regarding successful recanalization rate.
Association between Serum Neurofilament Light Chain Level and Cognitive Performance in Multiple Sclerosis Patients
Authors: Awad Eman Mahmoud , Ahmed Metwally Fatma Metwally , Nada Maha Ali Mohammed , Ibrahim Shaimaa Sayed 
Published: November 2024

Abstract

Background
Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system (CNS) in young adults causing demyelination in its nerve fibers which lead to axonal damage resulting in many potential symptoms physically, mentally and even psychiatric symptoms. It’s also an autoimmune disease so it’s a lifelong condition which progress along its course through life.

Aim of the Work
To study the relationship between cognitive function and serum level of (NFL) in patients with MS.

Patients and Methods
cross sectional pilot study conducted on 64 Patients with clinically definite relapsing remitting MS and recruited from the MS unit, Ain Shams university. 32 MS patients according to inclusion criteria and 32 MS patients with no cognitive impairment, as a control group. Both groups were between 20 to 40 years old.

Results
we found a strong connection between cognitive function (measured by the SDMT) and the level of sNfL. This suggests that higher levels of sNfL may be linked to poorer cognitive function in individuals with MS. Additionally, the study provides a cut-off value of &gt; 5.9, which can be utilized to classify cases as positive or negative.

Conclusion
found a highly statistically significant difference between the cases and the control group, indicating a strong relationship between cognitive function (measured by the SDMT) and the level of sNfL in patients with MS. This suggests that higher sNfL levels may be associated with worse cognitive function in MS patients. The cut-off value of &gt; 5.9 is also provided, which can be used to classify cases as positive or negative.
Assessment of Visual Memory in Idiopathic Pediatric Age Epilepsy
Authors: Tharwat Hoda Abdallah , EL-din Ahmed Nahed Salah , EL-Khayat Naglaa Mohamed , Bedros Rady Yousif 
Published: November 2024

Abstract

Background
Epilepsy is defined as “at least two unprovoked seizures occurring more than 24 hours apart or a single unprovoked seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years or a diagnosis of an epilepsy syndrome”. In epileptic patients, memory is the most affected domain of the cognitive functions. There are many contributing factors were proposed to affect visual memory dysfunction as duration of uncontrolled seizures, age of onset, frequency of seizures, dosage of antiepileptic drugs (AEDs), and abnormal epileptiform discharges on the electroencephalogram (EEG), number of antiepileptic drugs.

Aim of the Work
To determine the prevalence and risk factors of visual memory affection in children and adolescent with idiopathic epilepsy for better detection, management and quality of life.

Patients and Methods
This study was across sectional study for 50 pediatric epileptic patient aged from 8-18years old Ain Shams University hospitals, at pediatric neurology and epilepsy outpatient clinics with study period 6 month, met the inclusion and exclusion criteria. Benton visual retention test used to measure visual memory affection in pediatric epilepsy.

Results
A study on 50 pediatric patients showed that there is significant correlation between Benton & age in pediatric epileptic patients with P value &lt; 0.05. Also, it shows there is significant correlation between Benton and onset with P value &lt; 0.01. It also shows there is a significant correlation between Benton and duration of illness with P value&lt;0.05. It also shows there is a significant correlation between Benton and IQ with P value &lt; 0.01.

Conclusion
In conclusion, Benton scale is a appropriate assessment scale that indicate memory dysfunction. This study allowed us to detect the incidence of visual memory impairment among our pediatric patients and it also predicts the influencing factors. This is help us in management of our patients as this make us paid more attention for age, early age of onset, for duration of illness and IQ this will encourage early treatment and control of fits and will lead to early referral for cognitive rehabilitation and IQ assessment.
Effect of Heparin Reversal by Protamine Sulfate on the Outcome of Thrombolysis in Acute Ischemic Stroke after Percutaneous Coronary Intervention
Authors: Fawzy Khaled Fayez , Aref Hany Mohamed , Abd ElAziz Azza Abd ElNasser , Elbassiouny Ahmed Ali Ibrahim , Kenawy Fatma Fathalla , Shehata Emad Effat Fakhry 
Published: November 2024

Abstract

Background
Acute ischemic stroke (AIS) after percutaneous cardiac catheterization (PCI) is a known complication with incidence reports of ranges between 0.2% and 0.5%. It is associated with an in-hospital mortality rate of 20%, with markedly increased long-term mortality (1). Administration of Intravenous thrombolysis (IVT) is the recommended standard of care in acute ischemic stroke during the first 4.5 hours from stroke onset. However, current guidelines exclude intravenous thrombolysis in heparinized patients with partial thromboplastin time (PTT) greater than 40 seconds (2) Protamine is an efficient antidote known for the anticoagulant effect of heparin, and it can neutralize its effect within 5 minutes (3).

Aim of the Work
To assess the safety of IVT after heparin reversal by protamine sulfate in ischemic Stroke patients After PCI.

Patient and Method
The total number of patients who developed early IP stroke (within 4.5 hours from the end of PCI) was 42. All of them received loading antiplatelets before PCI.

Results
out of 21 patients received IVT after heparin reversal by protamine, no patient had died, 2 cases had non symptomatic intracranial hemorrhage (ICH), with significant improvement in stroke parameters and shorter length of stay

Conclusion
IVT following heparin reversal by protamine in appropriately selected AIS patients appears to be safe from a symptomatic ICH standpoint and may be beneficial. Extreme caution is warranted in applying these results to routine clinical practice. Rather, we suggest that thrombolysis may still be considered in AIS patients on therapeutic heparin who are not candidates for MT
Neurocognitive Changes in Adolescents with Synthetic Cannabinoids Use Disorder
Authors: Azim El Toukhy Lamyaa Abdel , Mohamed Ahmed Saad , Razik Mohamed Yasser Abdel , El Din Abdel Moneam Mohamed Hossam , Morsy Mahmoud Hassan Ali 
Published: November 2024

Abstract

Background
Synthetic cannabinoids are one of the most used novel psychoactive substances among adolescents with eminent adverse effects affecting cognitive functions and psychomotor performances. It was previously thought that undesirable effects brought by synthetic cannabinoids are more potent than organic cannabis products in terms of duration and intensity. This study aimed to assess the effects cannabis and synthetic cannabinoids on executive functions, whether persistent use is associated with their impairments and if related with the severity of addiction.

Methods
We recruited 60 male adolescents from Okasha Institute of Psychiatry, Helwan Psychiatric hospital, and El Sahel youth center being 20 synthetic cannabinoids use disorder, 20 cannabis use disorder and controls. Teens Addiction Severity index was performed, then assessment of cognitive functions by Wisconsin card sorting test, Wechsler memory scale revised, Trail making tests, Benton visual Retention test and neurological soft signs with Cambridge neurological inventory.

Results
No statistical significance found regarding neurological soft signs and Benton Visual Retention test. In Wisconsin card sorting test, synthetic cannabinoids patients are statistically higher in trials administered and trials to complete 1st category while tetrahydro-cannabinoid patients are statistically higher in perservative responses and errors. Regarding trail making tests, synthetic cannabinoids patients are statistically higher. Concerning Wechsler memory scale revised, controls are statistically higher in Verbal Paired Associates I and II, Visual Paired Associates I and II, and digit span total while synthetic cannabinoids were statistically higher in memory span total.

Conclusion
There is no difference in neurological soft signs, visual perception, and visual memory. Frontal lobe executive functions are affected between substance use patients; synthetic cannabinoids affected more regarding initial conceptualization ability while tetrahydro-cannabinoid patients affected more regarding cognitive flexibility. Regarding visual scanning and working memory, synthetic cannabinoid patients are more affected. Concerning different memory functions, substance use patients are more affected than controls with synthetic cannabinoid patients being more affected.
The Interplay between Intimate Partner Violence during Pregnancy and Birth Outcome
Authors: Ali Radwa Gomaa Ahmed , Nahas Gihan Medhat Mohammed E L , Ramy Ahmed Ramy Mohammed , Gamal El Missiry Marwa Adel , El-din Abd Elmoneam Mohamed Hossam 
Published: November 2024

Abstract

Background
Intimate partner violence is behavior by a partner or ex-partner that causes physical, sexual, or psychological harm and includes physical aggression, sexual coercion, psychological abuse, and controlling activity An earlier study in 2019 was conducted on the data collected from the 2014 Egypt Demographic and Health Survey (EDHS) revealed that the total prevalence of all forms of abuse was 29.4%.

Aim of the Work
To explore the association between prenatal exposure to intimate partner violence (IPV) among pregnant women to adverse birth outcome either maternal or neonatal. Compared to those who are not exposed to IPV. Explore socio-demographic and clinical correlates.

Patients and Methods
This study is a cross sectional Comparative Cohort study conducted at obstetrics and Gynecology in ASU hospital, in Cairo, Egypt. And the study period starting March 2023 till October 2023.

Results
there was significant correlation between exposure to emotional and harassment abuse and wife’s education, with P-value of 0.046 and 0.014 respectively. Yet, there was no significant correlation between wife’s education and exposure to severe combined abuse, physical abuse and neither with total composite abuse scale scores with P-values of 0.086, 0.921 and 0.136 respectively. No significant correlation between partner’s education and exposure to any type of abuse (severe combined abuse, physical abuse and harassment) and neither with total composite abuse scale scores with P-values of 0.569, 0.111, 0.399, 0.701 and 0.777 respectively. This may be because most of the woman in the Arab countries is thought that her golden role is to be house wife and no need for high level of education. we explored 15 adverse outcomes in the relation to exposure to IPV during pregnancy: psychiatric sequalae in mother (post-partum depression, postpartum anxiety), physical sequalae in mother (Preterm labor, premature rupture of membrane, gestational hypertension, gestational diabetes, vaginal bleeding, abnormal placentation, dehydration, urinary tract infection, spontaneous abortion, induced abortion), physical sequalae in neonate (intrauterine growth retardation, preterm birth (born before 37 completed weeks) and low birth weight&lt; 2500 g).

Conclusion
Involving 100 puerperal women, significant correlations were found between exposure to intimate partner violence (IPV) during pregnancy and various adverse outcomes, including preterm delivery and postpartum depression. The findings highlight the serious consequences of IPV on both maternal and neonatal health, with preterm birth rates being notably higher among women exposed to IPV.
Pain Characteristics in Egyptian Patients with Parkinson’s Disease
Authors: Mohamed Salma Reda , Shalash Ali Soliman Ali , Salem Haitham Hamdy , El Sayed Roushdy Tamer Mahmoud 
Published: November 2024

Abstract

Background
Parkinson’s disease (PD) is the most common movement disorder. The clinical findings of PD consist of cardinal motor features in addition to non-motor symptoms (NMS). Pain is one of the most common NMS in PD. The classification of pain in PD is still a matter of debate. However, in 2015, the King's Parkinson's disease Pain Scale (KPPS) was introduced as the first disease specific scale to assess pain in PD.

Objectives
To investigate the prevalence and severity of different types of pain in PD patients.

Patients and Methods
This cross-sectional observational study was conducted on 45 PD patients recruited from the movement disorder outpatient clinic at Ain Shams University Hospitals in which the KPPS was obtained from all participants.

Results
All the PD patients reported at least 1 type of pain. Regarding the number of pain types experienced per patient, 13.33% of patients had only 1 type of pain, 8.89% reported 2 types, and the majority (77.77%) had 3 types or more. Fluctuation- related pain was the most common (75.56%), followed by musculoskeletal pain (73.33%), nocturnal pain (68.89%), chronic pain (66.67%), edema/swelling (55.56%), orofacial pain (46.67%), then finally radicular pain (40%). The mean total KPPS score (reflecting both severity and frequency) in those patients was 39.73 ± 25.92 (range 1 – 98).

Conclusion
PD patients suffer from highly prevalent and severe forms of different types of pain. Therefore, proper assessment and management of different types of pain is essential for better care and QoL of people with PD. KPPS is an easy and fast tool to assess pain severity, frequency, and its different types.
Thrombi in Acute Stroke Patients: Histopathological Analysis after Mechanical Thrombectomy
Authors: Salem Haitham Hamdy , Elbassiouny Ahmed Ali Ibrahim , Ali Riham Ahmed Ibrahim , Atiah Amr Saeed , Mohamed Sameh Medhat 
Published: November 2024

Abstract

Background
The introduction of stent retrievers has made the complete extraction and histological analysis of human thrombi possible, although many studies have evaluated the retrieved thrombus by mechanical thrombectomy to assess its impact on success of acute stroke treatment, the results remain controversial, in this study we attempt to assess the impact of thrombus composition on mechanical recanalization, clinical outcome and stroke etiology.

Objective
Study the histopathological composition of thrombi extracted from acute stroke patients through mechanical thrombectomy, and correlate the findings with the causes of stroke, the imaging findings as well as thrombectomy efficacy in terms of the number of recanalization maneuvers, retrieval resistance, and time to achieve successful reperfusion.

Patients and Methods
The study was carried out at Ain Shams University hospitals to Patients presented to emergency department with large vessel occlusion and were candidate for mechanical thrombectomy. Participants were selected as sample sizes of 26 according to those meeting the inclusion Criteria for participant: patients with acute ischemic stroke with evidence of middle cerebral artery occlusion or internal carotid artery occlusion confirmed via cerebral angiography, Age ≥ 18 years old, NIHSS ≥ 6, Aspect score ≥ 6, time from onset to groin puncture is Within 24 hours, Patients for whom cerebral thrombus could be retrieved and collected during mechanical thrombectomy for histopathological analysis, and Agreement for written informed consent for participation or their nearest relatives in this study).

Results
In our study, Erythrocyte-rich thrombi were present in 16 cases, while fibrin-rich thrombi were present in 5 cases. A cardioembolic etiology was significantly more prevalent among the patients with erythrocyte-rich thrombi than among those with fibrin/platelet and a P- value of &lt; 0.001. Puncture to final reperfusion time was significantly highest in cases with RBC-rich with P-value of &lt; 0.001, and Number of passes needed to achieve reperfusion was significantly highest in cases with RBC-rich with P-value 0.002.

Conclusion
The current study showed Erythrocyte-rich thrombi were associated with a reduced number of recanalization maneuvers, shorter arrival-to-recanalization time interval, and more favorable clinical outcomes. This study also suggests that the histological composition of retrieved thrombi is significantly different between stroke subtypes. Cardioembolic thrombi have a higher percentage of erythrocytes and fewer fibrin/platelet than do non cardioembolic thrombi.
Iron Metabolism in Adult Patients with Epilepsy
Authors: Ahmed Nahed Salah Eldin , Nada Maha Ali , Mohamed Noha Refaat , Abdel-Aty El-Seady Somaya Hani 
Published: November 2024

Abstract

Background
Epilepsy is a disease characterized by recurrent, episodic, and transient central nervous system (CNS) dysfunction resulting from an excessive synchronous discharge of brain neurons and both the morbidity and mortality are high.

Objective
To compare between epileptic and non- epileptic patients regarding iron levels.

Patients and Methods
This case control study (pilot study) was conducted at neurology outpatient clinic, Faculty of Medicine, Ain Shams University Hospitals from August 2022 until July 2023.

Results
Our study outcome, serum iron level (mcg/dL) 158.45 ± 60.67 vs. 07.90 ± 29.92, serum ferritin (ng/mL) 187.76 ± 71.70 vs. 113.86 ± 42.75 and transferrin (iron) saturation % 45.87 ± 15.69 vs. 31.18 ± 5.57 were statistically significant higher among epileptic cases compared with control group. On the other hand, total iron binding capacity (mcg/dL) was higher 353.75 ± 98.07 vs. 343.85 ± 55.40 among epileptic cases compared with control group but with no significant value. Of note, there is no statistically significant difference between male and female, patient's age and duration of epilepsy according to iron profile in epileptic group. Also, there is no statistically significant difference between focal and GTC according to iron profile in epileptic group.

Conclusion
Iron overload is related to epilepsy. Increasing evidence demonstrates that epilepsy is closely related to ferroptosis and iron metabolism. Currently, there are many ways to regulate ferroptosis, but the regulatory mechanism of ferroptosis in epilepsy has not yet been understood. Targeting iron metabolism and ferroptosis may be a novel method to slow the progression of epilepsy. This type of treatment is yet to be discovered and explored. Nonetheless, ferroptosis is a newly identified and critical mechanism of cell death, especially in CNS disease. Anti-ferroptosis mechanisms and ferroptosis inhibitors play an essential role in preventing epilepsy.
Radiological Characteristics among Egyptian Patients Suffering from Incidental Cerebral Small Vessel Disease
Authors: Abdelhamid Yasmine Hassan , Aref Hany , Zakieldine Hany , Shokri Hossam , Hamid Eman , Youssef Mena Elerian 
Published: November 2024

Abstract

Background
Cerebral small vessel disease (CSVD) causes significant disability at increasing age such as cognitive impairment, gait, and sphincteric problems affecting a person’s quality of life. That is why it’s essential to detect and manage early. The aim of this study is to investigate the radiological progression among Egyptian patients suffering from incidental cerebral small vessel disease.

Aim of the Work
To investigate radiological progression among a sample of Egyptian patients with incidental CSVD.

Methods
Ninety-eight patients with CSVD underwent an MRI brain at baseline and after 12 months.

Results
Regarding MRI lesions, Visual rating scales did not show any significance between baseline and follow-up.

Conclusion
More sophisticated tools are needed to assess radiological progression in CSVD.
Comparison between Different Surgical Options for the Management of Symptomatic Intracranial Arachnoid Cysts: A Systematic Review
Authors: Ismail Mohamed Awad Mohamed , Hamza Abou Elmaaty Emad Maamoun , Hesham Elgayar Abdelrahman Mohamed , Mohamed Ibrahim Hammad Ahmed Mohamed 
Published: November 2024

Abstract

Background
Arachnoid cysts are non-neoplastic, intracranial cerebrospinal fluid CSF-filled spaces lined with arachnoid membranes. Small arachnoid cysts are mostly asymptomatic and may warrant watchful waiting and serial imaging follow-up. However, large arachnoid cysts are often symptomatic because they compress surrounding structures causing increased intracranial tension, fits, behavioral changes or visual hallucinations according to its site/size, therefore, they must be treated surgically. As several surgical management options exist, the best approach should be chosen according to each type of arachnoid cyst. Ongoing research aims to enhance our understanding of the clinical characteristics of these lesions, refine diagnostic approaches, and optimize treatment strategies to improve outcomes and quality of life for affected individuals.

Objective
The objective of this study is to compare between different surgical approaches in treatment of symptomatic intracranial arachnoid cysts mainly microscopic fenestration, endoscopic fenestration & cystoperitoneal shunt in terms of short and long-term effectiveness and complications in different types of arachnoid cysts.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2023.

Data Extraction
If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion
Further prospective randomized controlled trials are recommended to evaluate the surgical options, using clear and explicit criteria for inclusion, objective outcome definitions and assessment, and ensuring a consistent long follow-up to minimize the uncertainty in some data such as long-term complications and incidence of permanent deficits.