bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of Breast Elastography in Evaluation of Breast Masses on Screening Ultrasound
Authors: Youssef Martina Youssef Abdo , Ali Souzan Bahig , El-Aassar Maha Mahmoud , Mohamed Asmaa Magdy 
Published: November 2024

Abstract

Background
Breast cancer is a global health burden and a leading cause of death in females worldwide, breast cancer alone accounts for 25% of all cancer cases and 15% of all cancer death among females. Its high incidence has led to improve patient's mortality rate. Breast cancer is the most common female neoplasm (31% of tumors in females), and the second-leading cause of death among women.

Objective
To evaluate the additional value of Elastography as complementary to conventional US in breast masses found on screening US.

Methods
The study was performed prospectively between August 2022 and January 2023 at Ain Shams University hospitals at diagnostic radiology department in 30 consecutive female patients who met all the inclusion criteria with no exclusion criteria.

Results
A total of 30 patients were included in our study with a mean age of 39.40 years (range 17 - 79 years). On Histopathological Evaluation, 9 (30%) lesions were malignant and 21(70%) were benign. The calculated sensitivity of Semiquantitative Elastography was 100%, specificity was 95.2% and the total accuracy was 96.7%. The PPV & NPV were 90% & 100% respectively. In our study, the best cut off value for Strain Ratio to differentiate between benign and malignant breast entities was found to be at 3.6 level (AUC, 0.984). It allowed significant differentiation between benign and malignant lesions (p &lt; 0.001). Which considering lesions with a Strain Ratio ≤ 3.6 as benign and lesions with a Strain Ratio &gt; 3.6 as malignant.

Conclusion
Breast Ultrasound Elastography is a useful imaging modality resulting in increase specificity and sensitivity in diagnosing different breast lesions. Breast Elastography provides useful information about distinguishing benign and malignant lesions. Thus, consideration of lesion stiffness could increase positive predictive values and reduce unnecessary benign biopsies and render better diagnostic results.
Role of MR Cholangiopancreatography in the Diagnosis of Various Pediatric Hepatic and Pancreatobiliary Diseases
Authors: Nassar Nasma Mohamed , Mohammad Shaimaa Abdelsattar , Salah Shaymaa Hassan Mohamed 
Published: November 2024

Abstract

Objective
The aim was to determine the role of MR cholangiopancreatography in the diagnosis of various hepatic and pancreatobiliary diseases in children and to correlate the MR imaging findings with the clinical data, laboratory results and the findings of the available other imaging modalities.

Patients and Methods
The present study retrospectively included 83 patients, with signs and symptoms denoting hepatic and pancreatobiliary abnormalities, who underwent paired radiological examination using US and MRI. MRCP examinations are coronal 3D fast spin-echo HR MRCP sequence, as well as axial and coronal T2-weighted fast spin-echo and fat-suppressed sequence images, axial DWI using a multi-slice single-shot echo-planar imaging sequence and ADC maps in gray scale. Agreement between US and MRI was done as regards identification of individual radiological abnormalities, diagnostic accuracy of US vs. MRI as gold-standard modality for detection of IHBRD and EHBRD was tested, and also diagnostic accuracy of US and MRI versus final (gold-standard) diagnosis was calculated.

Result
MRCP was found to have significantly higher diagnostic accuracy when compared to ultrasound (90.2%, 41.0%) respectively, especially in detection of pancreatic lesions (p-value &lt;0.0001). Although there was good agreement between US and MR as regards detection of IHBRD and EHBRD, it was found that the US had a sensitivity of 69%, specificity of 90%, predictive value of positive test of 81%, predictive value of negative test of 82% for diagnosis of IHBRD and had sensitivity of 64%, specificity of 100%, predictive value of positive test of 100%, predictive value of negative test of 81%, when contrasted versus MRI as the gold-standard test.

Conclusion
MRCP have a higher diagnostic accuracy compared to US in detecting various hepatic and pancreatobiliary disease in children, especially in diagnosis of pancreatic diseases.
Assessment of Treatment Response in Patient of HCC by ADC Histogram Post-TACE in Correlation with Modified RECIST
Authors: Azzab Enas Ahmed , Mohammed Marwa Sayed , El-Rahman Ali El Saied Abd , Desouky Rania Mostafa Mahmoud El 
Published: November 2024

Abstract

Background
Hepatocellular carcinoma (HCC) is the fifth most common cancers worldwide, and has a poor prognosis unless treated. Trance arterial chemoembolization is promising treatment option for patients with liver HCC who are not eligible for surgery.

Objective
The aim of this study is assessment pre & post TACE imaging based on histogram analysis for predicting response of the treatment in patients diagnosed with hepatocellular carcinoma (HCC).

Patients and Methods
This work was a prospective study conducted on 30 patients with HCC; to assess therapeutic response of HCC cases after TACE by ADC histogram in comparison to mRECIST to evaluate its role in detecting treatment response /residual tumor.

Results
According to CART test, out of 30 patients, 12 (40%) showing a Complete response, indicating a favorable outcome where the treatment successfully reduced the tumor burden, 14 patients (46.67%) demonstrated a Partial response, suggesting a significant reduction in tumor size or overall improvement in disease status as well as 4 patients (13.33%) had a Stable response, indicating that their disease remained relatively stable without significant progression or regression. So, There is a statistically significant correlation between the responses categorized the mRECIST methods and CART test (P = 0.013).

Conclusion
changes in mean ADC and ADC kurtosis, as a measure of change in tissue heterogencity, can be used as quantitative values to assess post TACE treatment response in patient with well-circumscribed HCC.
Magnetic Resonance Imaging in Evaluation of Cystic Renal Masses Using Bosniak Classification Version 2019
Authors: Ahmed Samar Ahmed Abdallah , Kotb Mohamed , Madkour Sherihan Said , Hussein Rasha Salah Eldin 
Published: November 2024

Abstract

Background
Cystic renal lesions are very commonly encountered at abdominal imaging. Most lesions are asymptomatic and incidentally found. When a confident diagnosis cannot be rendered, incidental renal masses are considered indeterminate and typically are furtherly evaluated with CT or MRI using Bosniak classification that is specifically designed to evaluate them.

Objective
To assess MRI in evaluation of cystic renal masses using Bosniak classification version 2019 to stratify the risk of malignancy in correlation to histo-pathological analysis.

Patients and Methods
This was a cross sectional study that included 60 patients who were diagnosed to have cystic renal lesion either outpatients or referred from the urology department at Ain Shams University Hospitals to the radiodiagnosis department For pelvi-abdominal MRI examination. An acceptance from the ethical committee of the Radiology Department and the ethical Committee of faculty of medicine - Ain Shams University hospitals was obtained to use the data stared on PACs system With the patient’s consent waived. All patients gone through MR assessment utilizing 1.5 T machine (inginea Philips).

Results
From our study simple renal cyst (bosniak I) were the most common benign lesion and Cystic renal masses classified as Bosniak IV were the most common malignant lesion. After exclusion of benign causes 17 cases were included in histopathology. Clear cell Renal cell carcinomas were the most common finding and we correlate Histopathology with MRI results and It shows high significant relation between Bosniak classification and histopathology.

Conclusion
Bosniak classification version 2019 has high sensitivity and specifity in correlation to histopathology.
Comparison between Digital Breast Tomosynthesis and Digital Mammography in the Assessment of Breast Cancer across Dense and Nondense Breast
Authors: Abdelrahman Sanaa Hussein , Nasr Merhan Ahmed , Hanna Chris Nabil 
Published: November 2024

Abstract

Background
Women's breast cancer is considered a serious public health issue. throughout the world. For asymptomatic women, digital mammography is the primary imaging modality used for breast cancer screening. It also has been shown to reduce breast cancer mortality. Digital breast tomosynthesis provides better detection of the abnormalities especially in females with dense breasts

Aim
to evaluate the impact of digital breast tomosynthesis (DBT) in comparison to digital mammography (DM) in improving the detection and characterization of breast cancer across the dense and non-dense breasts (according to BI-RADS Atlas) in correlation with ultrasound and histopathology.

Material & Method
This study included 100 female patients according to our inclusion criteria. All patients performed full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) were classified according to breast density. To establish a correlation between mammographic findings and cancer diagnosis, high-resolution ultrasound (HHUS) and DBT were used following FFDM as the primary imaging modality. The cancer diagnosis was subsequently confirmed by histopathology.

Results
The current study was based on histopathology as a reference standard, This was correlated with the final diagnosis; the diagnostic indices of mammography at the whole group were a sensitivity of 73.9%, a specificity of 74.3%, a positive predictive value (PPV) 84.2%, a negative predictive value (NPV) of 60.5%, and a diagnostic accuracy of 74%. Diagnostic indices of DBT were a sensitivity of 100%, a specificity of 88.6%, a PPV of 94.2%, an NPV of 100%, and a diagnostic accuracy of 96%. In patients with dense breasts Radiology ACR (c and d), 78% of cases had changed their BI-RADS scoring with the addition of tomosynthesis. However, in 54% of individuals with non-dense breast ACR (a and b), the addition of DBT to FFDM changed the BIRADS score. Our results showed that 100% of lesions detected by tomosynthesis were malignant tumors.

Conclusion
We conclude that DBT exceeded Mammography in terms of sensitivity, specificity, and diagnostic accuracy at all breast densities, particularly dense breasts. This is because DBT enables more accurate identification and characterization of breast lesions, which reduces the number of recalled cases and negative biopsies.
Antenatal Ultrasound Measurement of Fetal Abdominal Subcutaneous Tissue Thickness as a Predictor of Fetal Birth Weight
Authors: Shawky Abdeltawab Taha Shoeib Sherouk Ahmed , Sakr Hossam Moussa , Mohammed Hesham Salah 
Published: November 2024

Abstract

Objectives
To correlate fetal abdominal subcutaneous tissue thickness (FASTT) measured by transabdominal ultrasound and birth weight measured immediately after delivery and to obtain cut-off values for FASTT to predict small and large for gestational age babies in the Egyptian population.

Background
Fetal weight estimation is a crucial part of antenatal and intrapartum care as it forms the basis for decision making in obstetric care. Various studies compared the accuracy of different ultrasound fetal weight estimation formulas to determine the most accurate one, but current evidence still indicates significant error levels. FASTT measurement can be used to improve ultrasonographic fetal weight assessment reducing potential perinatal complications associated with small and large for gestational age fetuses.

Patients and Methods
A prospective cohort study conducted in Ain Shams University Hospitals on 86 pregnant women with normal singleton pregnancies between 24 and 40 weeks of gestation. FASTT was measured in millimeters at the anterior third of the abdominal circumference and birth weight was recorded immediately after delivery.

Results
This study concluded that FASTT showed high statistically significant correlation with EFW by Hadlock formula IV (1985) (r = 0.624, p- value = &lt;0.001) and BW (r = 0.749, p- value = &lt;0.001). FASTT showed higher sensitivity (84.09%) than specificity (64.29%) as a predictor of both SGA and LGA, but it showed higher sensitivity and specificity in LGA (sensitivity 100%, specificity 97.5%) compared to SGA (sensitivity 81.1%, specificity 73.5%). The best cut-off value of FASTT for LGA was 7.1 mm and that of SGA was 4.9 mm. No statistically significant correlation was found between FASTT and any of the maternal age, fetal gender or mode of delivery.

Conclusion
FASTT can be used as a predictor for birth weight; it is a better indicator of LGA than SGA. FASTT can be incorporated into fetal weight estimation formulas as a method to increase their accuracy especially at birth weight extremes. A study on a larger scale of Egyptian population should be conducted to generate fetal weight estimation formulas based on the Egyptian ethnicity to be the reference for medical practice in Egypt.
Repetitive Transcranial Magnetic Stimulation as a Modality of Treatment in Patients with Fibromyalgia
Authors: Sebaie Mona Abdallah El , Ahmed Sahar Fathi , Nassef Marwa Abdelaziz , Abd rabbo Rawan Mohammed El Shahat 
Published: November 2024

Abstract

Background
Fibromyalgia is a common musculoskeletal condition affecting around 1–3% of the general population worldwide. It is defined as a complex chronic disorder characterized by widespread musculoskeletal pain and tenderness, often accompanied by additional features including fatigue, sleep disturbance and cognitive dysfunction and is associated with co-occurring health issues including mood disorders.

Aim of the Work
The aim of this study is to evaluate the role of repetitive transcranial magnetic stimulation (rTMS) in treatment of fibromyalgia.

Patients and Methods
The study was conducted on 30 primary fibromyalgia patients according to American college of rheumatology criteria (ACR) 2010 criteria 20 of which were subjective to repetitive transcranial magnetic stimulation (rTMS) and 10 subjected to Sham stimulation (placebo) as a control group.

Results
As regards the quality of life assessment after rTMS sessions, there was a highly statistically significant difference in feel good and work missed scores by FIQ being lower in cases group compared to control group with p-values 0.008 and 0.003 respectively. Also there was a statistically significant difference as regards physical impairment, anxiety and depression scores by FIQ being lower in cases group compared to control with p-values 0.013, 0.022 and 0.037 respectively. On comparing the control and cases groups regarding anxiety and depression using HADS questionnaire after rTMS sessions, there was a statistically significant difference in depression score as it was lower in cases group compared to control group with p- value 0.024. Regarding fatigue assessment after rTMS sessions, there was a highly statistically significant difference between both groups as regards energy/fatigue, general health and health change scores being higher in cases group compared to control group with p-values 0.004, 0.005 and 0.009 respectively. Also, there was a statistically significant difference regarding emotional well-being score which was higher in cases group compared to control group with p-value 0.012. Upon correlating age and BMI with the studied parameters among the cases group, our results showed a positive correlation between age and pain score by FIQ (r 0.049, p 0.028), But, there was no correlation between BMI and other studied parameters.

Conclusion
rTMS was more effective than sham stimulation in improving quality of life, anxiety and depression when patients were assessed approximately 3 weeks after therapy. But, it was not effective concerning pain improvement.
Incidence of Multidrug Resistant Organisms and Adequacy of Empiric Antibiotic Treatment in Hospitalized Patients with Sepsis at Ain Shams University Hospital
Authors: El-Sayed Ashraf M , Ali-eldeen Fatma A , Mubarak Hend , Ali Yasmeen M , Abousenna Ahmed M 
Published: November 2024

Abstract

Background
Bloodstream infections (BSIs) are the most severe infections that cause the highest mortality rate, especially in patients admitted to the intensive care unit (ICU). The nightmare of the rising numbers of multidrug-resistant organisms (MDROs) requires the implementation of effective Antibiotic stewardship programs (ASPs). However, this should be preceded by making available evidence-based knowledge regarding the local antimicrobial resistance pattern, which is fundamental.

Objective
Is to determine the prevalence of MDROs and to measure the adequacy of the empirical Anti-Microbial Therapy (EAMT) in adult patients with sepsis hospitalized at Ain Shams University Hospitals (ASUHs) ICUs.

Patients & Methods
This was a prospective cohort study carried out on hospitalized adult patients with evidence of BSI admitted at ICUs of ASUH by +ve blood culture and sensitivity results. 276 patients were included in the study during the period from December 1st 2022 till may 30th 2023.

Results
In 276 patients, our study showed male to female ratio 1:1.1, Community acquired infections account for 34.8%, while healthcare associated infections account for 65.2% of total cases. The primary source of BSI was identified in only 62% of cases; the most prevalent cause was UTI in 29.1%, and pneumonia in 16.6% of total cases with identified source. Prevalence of MDROs was 88.8% among all the studied patients, Klebsiella spp. was the most prevalent among isolated organisms in 30.8% of total cases, and adequacy of EAMT was achieved in only 40.9% of total cases. Mortality rate within 2 weeks was 23.2%, and long hospital stay &gt; 2weeks noticed in 54.3% of the studied patients and only 22.5% of patients improved and discharged from ICU.

Conclusion
MDROs are a public health threat and their prevalence is rising over the past few years, effective ASPs are mandatory to combat that threat and improve the adequacy of EAMT.
Characteristics and Outcome of Primary Budd Chiari Syndrome due to Myeloproliferative Disorder in Egyptian Patients, A Single Center Study
Authors: Ibrahim Amany Ahmed , Mubarak Hend , Ganzoury Ahmed El , Hassan Sarah , Hakeem Emad Abdel 
Published: November 2024

Abstract

Background
Budd–Chiari syndrome (BCS) is a rare life-threatening disorder caused by obstruction of the hepatic venous outflow tract at any level between the small hepatic veins and the right atrium, hence also known as hepatic venous outflow tract obstruction (HVOTO). Primary BCS is often related to multiple thrombophilic conditions, including primary myeloproliferative disorders.

Aim of the Work
The present study aimed to assess characteristics of Primary Budd Chiari syndrome due to Myeloproliferative disorder in Egyptian patients and the outcome of the radiologic endovascular intervention (TIPS or angioplasty)

Patients and Methods
This was a retrospective cohort study that was carried out in The Tropical Medicine department, at Ain Shams University Hospitals. A total of 37 patients were enrolled, including 12 males and 25 females, with an age of 15-49 years (mean: 32 years) with primary BCS and MPDs during the interval between January 2006 and March 2023.

Results
JAK2 was positive in 64.9% of BCS patients, more in ET patients. ET was more frequent in BCS due to MPDs. Furthermore, these results validate routine inclusion of JAK2V617F in the diagnostic workup of BCS. Rate of stent occlusion was high 33.3% due MPDs thrombophilic burden nature.

Conclusion
MPDs are major aetiology of BCS. TIPS placement is an effective treatment for portal hypertension, but in any case, long-term high intensity anticoagulation treatment is essential in order to prevent recurrent thrombosis.
Prognostic Value of CLIF-C of Score in Patients with ACLF (Acute on Top of Chronic Liver Cell Failure)
Authors: Abdelhamid Khalaf Mohamed Salaheldin , Elgazar Ahmed Hussein Abdelhamid , Alfeqy Israa Mohamed Mohamed 
Published: November 2024

Abstract

Background
ACLF is a major cause of mortality in patients with cirrhosis and chronic liver disease worldwide. An international consensus definition for ACLF is currently lacking and thus there is heterogeneity in how these patients are identified and subsequently managed in different settings. Whilst it is clear that early diagnosis, prevention of precipitating factors, and aggressive ICU care with organ support improves prognosis; treatment for ACLF is currently broadly restricted essentially to supportive care.

Objective
To evaluate the prognostic accuracy of CLIF-C ACLF score in determining short-term (28-day) mortality in patients with acute on top of chronic liver cell failure presented to Ain Shams University Hospitals.

Methods
This was a retrospective cohort study that was carried out in Ain Shams university hospitals (Tropical Medicine Department, Intermediate Care unit). 70 patients (47 males, 23 females) were studied in retrospective manner in the period from 12/2019 to 12/2021 in the form of collecting records of patients with Acute on top of Chronic liver cell failure ACLF to evaluate the prognostic value of CLIF C ACLF score in patients with ACLF to predict the 28 day mortality.

Results
CLIF-C ACLF score has shown better accuracy in predicting short term 28 day mortality for patients with ACLF compared with all other tested prognostic scores for chronic liver disease in patients with ACLF, especially for ACLF grade 3.

Conclusion
ACLF-specific scores could significantly predict in-hospital mortality of patients with ACLF. However, CLIF-C ACLF and Child-Pugh class C were superior to other scores as they could significantly and independently predict in- hospital mortality. Cirrhosis patients who were hospitalized due to acute liver decompensation with or without ACLF had a high short-term mortality rate. The CLIF-C ACLF score demonstrated the best accuracy in predicting the prognosis of ACLF patients. The prognosis of AD patients was poorer than that of other populations.