bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Intra-Abdominal Adhesions with Ultrasonographic Sliding Sign in Third Trimester Women Prior to a Repeated Cesarean Section
Authors: Farid Mohamed Kassem Ahmed Mohamed , Ismail Abdel-Megeed Abdel-Megeed , Abdelnasser Ahmed Gamal , Mahmoud Riad Amr Ahmed 
Published: November 2024

Abstract

Background
Adhesions are the most frequent complication following abdominal and pelvic surgery, developing after more than 90% of interventions concerning the abdominal cavity. Consequences include infertility, chronic pelvic pain and small bowel obstruction. Adhesions increase the complexity of future surgery by increasing the risk of urinary tract and intestinal injury, and by increasing the operative duration and thus the risk of blood loss.

Objective
To evaluate the efficiency of preoperative transabdominal ultrasonographic features in prediction of intra-abdominal adhesions in pregnant women during third-trimester with history of previous cesarean section surgery scheduled for a planned repeated elective C.S. delivery.

Methods
After ethical committee approval and informed consent from the patients, this prospective study was performed on total 200 third-trimesteric pregnant women with history of previous cesarean section who admitted for elective caesarian section and willing to participate in the study to investigate the value of the sonographic evaluation in predicting the intra-abdominal adhesions at tertiary care hospital at Ain Shams University Maternity Hospital from January 2023 till October 2023 and performed on total 200 patients who underwent elective caesarean delivery.

Results
The findings of our study demonstrated a good capability of a simple third-trimester transabdominal sonographic sign, the absence of sliding of the uterus, to predict the presence of intra-abdominal adhesions in women undergoing repeat CS.

Conclusion
We concluded that the real-time dynamic transabdominal ultrasound sliding sign is a non-invasive, well-tolerated technique. Its preoperative analysis in patients who have had previous abdominopelvic surgery may help to evaluate the risk of bowel or bladder injury and the complexity of the planned intervention, improving the safety of surgery, and may help to inform the anesthesiologist regarding the expected duration of the intervention and any potential complications during the procedure.
Laminiria Tents versus Vaginal Prostaglandin in Cervical Ripening in Term Induction of Labor with Unfavorable Cervix: A Randomized Controlled Trial
Authors: Mohamed Ahmed Mohsen Hassan , Abou El Nour Ayman Abdul Razek , El Sabaa Haitham AbdelMohsen , Abdelrazek Maya Mahmoud 
Published: November 2024

Abstract

Background
Mechanical methods used for induction of labor received a great attention nowadays due to the serious side effects of the pharmacological methods. Hygroscopic dilators are considered important subtype of these mechanical methods. One of them is Laminaria which is a synthetic type of sea algae that induces cervical dilation by absorbing water from the cervix and gradually increasing in thickness.

Objective
To compare the effectiveness and safety of Laminiria tents to intravaginal prostaglandins for cervical ripening in induction of labor at term gestation in women with unfavorable cervix.

Methods
A total of 90 pregnant women at term gestation with unfavorable cervix admitted to the labor ward for induction of labor at Ain Shams University Maternity Hospital, in the period from March 2022 to March 2023, were enrolled in the study and underwent assessment using Bishop score with monitoring differences between two groups in mode of delivery, time to enter active phase, time to delivery, changes in bishop score and noted complications. This study was registered on clinicaltrials.gov with number (NCT06151925)

Results
In the present study we demonstrated that in laminaria group, there was 66.7% had NVD and 33.3% had CS while in prostaglandin group, there was 71.1% had NVD and 28.9% had CS in which there was no statistically significant difference between laminaria and prostaglandin groups regarding routes of delivery. In this study we demonstrated that Time needed to enter active phase (hours) in laminaria group was 16 (10 – 19) while in prostaglandin group was12 (8 – 16) in which there was a statistically significant difference between laminaria and prostaglandin groups regarding Time needed to enter active phase (hours) (p = 0.022). In this study we demonstrated that regarding induction delivery time (hours) in laminaria group was 20 (13 – 25) while in prostaglandin group was 16 (11 – 20) in which there was a statistically significant difference between laminaria and prostaglandin groups regarding induction delivery time (hours) (P = 0.036).

Conclusion
Vaginal prostaglandin is more effective than laminaria tent for ripening of cervix before induction and can decrease labor duration and time to delivery. However, for better results further studies with a larger sample size are recommended.
The Outcomes of Second Trimesteric Induction of Abortion in Previously Scarred Uterus at Ain Shams Maternity Hospital
Authors: El guindy Alaa Eldin Abdel-Aziz , Mohyi Eldin Maii Medhat Nawara , Taha Felfela Taha Samir 
Published: November 2024

Abstract

Back Ground
Termination of pregnancy by induced abortion is one of the commonest procedures, Pregnancy termination in case with prior cesarean delivery becomes an increasingly common situation facing obstetricians due to progressive increase in the rate and incidence of cesarean births.

The aim of the Study
was to assess and evaluate the outcomes of second trimesteric induction of abortion in previously scarred uterus.

Methods
this was a retrospective study curried at Ain Shams Maternity Hospital at the period from the 1st of January 2018 till the 31st of December 2020.

Results
Patients subjected to hysterotomy received significantly higher dosed of misoprostol compared with those who did not undergo hysterotomy (median [IQR] = 1100 [800 – 2400] mg versus 800 [500 – 1600] mg, respectively; p= .047).

Conclusion
There were 15.5% suffered failed medical abortion and 1.5% rupture uterus with difficulty to correlate this event to the dose of the medication used for induction. Increased gestational age, history of 3 or more CS, and presence of &gt; 1 gestational sac was independently associated with decreased probability of successful medical abortion. Higher total dose of misoprostol was only marginally associated with decreased probability of success. On the other hand, higher hemoglobin level is independent predictor of successful medical abortion. Patients subjected to hysterotomy received significantly higher dosed of misoprostol compared with those who did not undergo hysterotomy.
Survival Benefit from Total Neo-Adjuvant Therapy in Locally Advanced Rectal Cancer Patients
Authors: Azmy Aly Mohamed , Mosalem Nesreen Ahmed Elsayed , Mostafa Mohamed Yassin , Saleh Mohammed Essam , Ahmed Hager Reda Mohammed 
Published: November 2024

Abstract

Background
Preoperative chemoradiation in patients with locally advanced rectal cancer has no impact on overall survival (OS) and distant recurrences. The aim of the study was to evaluate local downstaging, toxicity, patient compliance and long-term outcome (2 year OS and DFS) in patients with locally advanced rectal cancer after induction chemotherapy with 12 weeks of 5 fluorouracil based chemotherapy followed by radiotherapy concomitant with capecitabine before total mesorectal excision (TME).

Patients and Methods
Between January 2018, and December 2019, we enrolled eligible patients with poor-risk rectal cancer defined by high-resolution MRI (Any cT3 and T4 stage, T2 low lying tumor at or below the levators and node positive tumor) and without metastatic disease Patients were planned for 12 weeks of neoadjuvant capecitabine and oxaliplatin (oxaliplatin 130 mg/m² on day 1 with capecitabine 1000 mg/m² twice daily for 14 days every 3 weeks) followed by chemoradiotherapy (50.4 Gy in a conventional fractionation) with capecitabine (825 mg/m² twice daily), then total mesorectal excision (TME) was carried out 6 weeks after the completion of CRT.

Results
Of 70 consecutively admitted patients starting induction chemotherapy, 55 patients underwent surgery. R0 resection was seen in 92.7% and pathological downstaging in 72.7%. In the intention-to-treat group, Objective response rates after neoadjuvant chemotherapy and chemoradiotherapy were 51.4% and 48.6%, respectively. Pathological complete response was seen in 15.7 %. Two-year disease-free survival (DFS) and OS were 62.5% and 82.6%, respectively. Grade 3/4 toxicity was seen in 20 %, and only one case died within 2 months of therapy.

Conclusion
Intensification of systemic therapy with neoadjuvant combination chemotherapy before standard treatment is feasible in poor-risk potentially operable rectal cancer, with acceptable safety and promising long-term outcomes. Future development of this multidisciplinary treatment strategy in randomized trials is warranted.
Comparative Study between Acute Side Effects in Patients Treated with Brachytherapy versus External Beam Radiotherapy in Early Stage Endometrial Cancer
Authors: Mohamed Elgabalawy Manar Adel Abd El Monaem , Mohamed Ehab Moustafa , Adel Azza Mohamed , Qady Mohamed Sabry Al , Meckawy Ghada Refaat , Mohamed Sara Essam 
Published: November 2024

Abstract

Background
Adenocarcinoma of the endometrium is the most common malignancy of the female genital tract. The main line of treatment of early stage endometrial cancer is total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adjuvant radiotherapy either external beam radiotherapy or vaginal brachytherapy.

Aim of the Work
To compare acute toxicities between patients who received adjuvant high-dose- rate (HDR) vaginal brachytherapy (VBT) and those who received external beam radiotherapy (EBRT) in early stage endometrial cancer.

Patients and Methods
This is a retrospective study was conducted on 62 patients with histologically proven endometrial carcinoma at the Clinical Oncology Department, Ain Shams University Hospitals, Cairo, Egypt for 6 months from January 2020 to December 2022.

Results
The results of this study showed that different side effects were less frequent in HDR VBT group than in EBRT group, the differences were statistically significant only in nausea, diarrhea, bleeding per rectum, dysuria, abdominal pain, bony aches and skin toxicity. Among cases with acute side effects, grades of side effects were lower in HDR VBT group than in EBRT group, but the differences were statistically non-significant.

Conclusion
HDR-VBT may be a less toxic option than EBRT for the adjuvant treatment of early stage endometrial cancer. However, more research is needed to confirm these findings and to better understand the long-term risks and benefits of each treatment option.
Efficacy and Safety of SARS-COV-2 Vaccines in Breast Cancer Patients
Authors: Canaan Mira Youssef Robert , Abdulla Hatem Mohamed , Al-Kady Mohamed Sabry , Gomaa Nada Ezzeldin , Mohammed Fahim Noha Alaa El-Din , Sherif Diaa Eldin Moussa 
Published: November 2024

Abstract

Background
Breast cancer (BC) is a major public health problem. COVID-19 pandemic impacted all areas of daily life, including medical care. In particular, delivering care for patients with cancer or suspected cancer during the crisis was challenging given the competing risks of death from untreated cancer versus serious complications from SARS- CoV-2, and the likely higher lethality of COVID-19 in immunocompromised patients.

Aim of the Work
This study aims to assess the efficacy and immunogenicity of SARS COV 2 vaccines in breast cancer patients by evaluating anti spike antibodies in vaccinated and non vaccinated patients and also through assessing the infection with covid after vaccination (in vaccinated patients) and in non vaccinated patients. The study also aims to assess the Safety of SARS COV 2 vaccine in breast Cancer patients (local and systemic Toxicity).

Patients and Methods
Our population consisted of 120 female patients diagnosed with early and locally advanced breast cancer, in the breast cancer unit, Clinical oncology department, Ain Shams University Hospitals. All on systemic therapy (on neoadjuvant or adjuvant treatment). Sixty vaccinated and 60 unvaccinated against COVID-19. The cutoff value of SARS COV-2 antibody is 50 BAL/mL (&gt;/= 50 seropositive, &lt;50 seronegative)

Results
Out of 120 patients, Anti-SARS COV-2 Antibody seropositivity was found to be 48 vs. 58 pts (80% vs. 96.7%) in non vaccinated Vs. Vaccinated patients, with a P-value=0.0046), which was statistically significant. The median titre in both groups was found to be 1434.5 vs. 2500, (P = 0.0026). In the 120 patients, 26 patients had covid infection with a significant difference, Non vaccinated Vs. Vaccinated: 21 vs. 5 pts (35% vs. 8.3 %, P = 0.0004). In the sixty vaccinated patients, mild local adverse events were reported such as warmness at site of injection in 17 patients, representing (28.3%) of patients, Pain 11 (18.3%), Swelling 11 (18.3%), Itch 8 (13.3%), and Redness 6 (60%) representing the least adverse event. The patients experienced mild systemic adverse events, the highest incidence was Fatigue 28 (46.7%), then Myalgia/arthralgia 17(28.3%), headache 2 (3.3%),and fever 16 (26.7%).

Conclusion
Anti SARS COV2 are effective and safe in localized breast cancer patients on systemic therapy.
Correlation between Clinicopathological Features of Soft Tissue Sarcoma and Clinical Outcomes; A Retrospective Study
Authors: Elsayed Noha Mohamed Elsayed , Riad Atef Youssef , Gaballah Ahmed Mohamed , Nofal Ahmed Maamoun , Hussein Mariam Mohamed , kelany Mohamed Reda 
Published: November 2024

Abstract

Background
Sarcoma is a rare and diverse mesenchymal cancer that accounts for fewer than 1% of all adult cancers and 10% of paediatric tumours. Around 11,000 new cases are diagnosed each year in the United States, accounting for &lt;1% of all cancers. Approximately 80% of sarcoma originate from soft tissue, and the rest originate from bone. Most sarcomas (about 55%) affect mainly the extremities, mostly the legs, and about 15% affect the head and neck area or trunk, the rest are retroperitoneal or intraperitoneal.

Objective
The primary objective is to determine the clinicopathological features and treatment strategies of soft tissue sarcoma and its correlation to clinical outcomes in the form of Overall survival, Disease free survival and Progression free survival in the period from January 2017 to December 2021.

Methods
This study is a retrospective study that included 151 patients diagnosed with soft tissue sarcoma attending the sarcoma unit at the Clinical Oncology Department, Ain Shams University, in the period between the start of January 2017 to the end of December 2021

Results
151 patients were eligible for overall survival evaluation in which median OS was 80 months. Disease free survival was calculated in 133 patients in our study with median DFS 36 months. Patients presented with metastasis from the start represented 10.5% of the population. Meanwhile 23% of the studied population developed metastasis later on, with median PFS 17 months. The most common site of metastasis was lung in 36.5%. Metastasis at initial presentation had a negative impact on overall survival with p value &lt; 0.001. Resection margin had high impact on overall survival outcomes and recurrence with p value &lt;0.001 and &lt;0.018, respectively. Other clinicopathological factors that had a statistical significance on OS and DFS and local recurrence were; Age, ECOG, tumor size, stage and resection margin.

Conclusion
STS represents a heterogenous group of malignancies that require multidisciplinary team and referral to experienced tertiary centers. Treatment patterns for STS have evolved with increased utilization of neoadjuvant radiation therapy for patients diagnosed with resectable disease aiming for less toxicity with lower dose and smaller treatment volume, limb sparing surgery with free resection margins and better quality of life. We concluded that the most significant predictors of survival and prognostic factors are; stage at initial presentation, type of surgery and margin status.
Correlation between Molecular Subtype and Clinicopathological Characteristic in Breast Cancer Patients Retrospective Study
Authors: Elshamely Shaimaa Hamdy Faried , Sayed Ismaael Souhair , Tawfik Amr Shafik , Meckawy Ghada Refaat , Faheim Reham Mohamed , Hakem Sherif Hassanien Ahmed 
Published: November 2024

Abstract

Background
Breast cancer is the most common malignancy in women and the fifth cause of cancer mortality worldwide. Breast cancer is a heterogeneous disease characterized by a wide spectrum of many subtypes with distinct biological features that lead to differences in clinicopathological presentation.

Aim of the Work
To correlate clinicopathological characteristics and molecular subtypes and estimate the distribution of breast cancer (BC) subtypes and characteristics.

Patients and Methods
This is a retrospective study that was conducted on 1413 female patients diagnosed with breast cancer in the Clinical Oncology department, at Ain Shams University Hospital from January 2018 to December 2020 to study the correlation between clinicopathological staging and molecular subtype.

Results
The study found that luminal A and luminal B HER2-negative were the most common molecular subtypes of breast cancer in the studied population, and there was a significant association between post-menopausal status and these subtypes. There was a significant association between clinical/pathological staging and different molecular subtypes. Patients with higher age or Ki67 &gt; 14% were more likely to have higher stages of breast cancer.

Conclusion
Molecular subtype of breast carcinoma should routinely be done for all cases of carcinoma breast. They provide valuable information not only about response to therapy but also about possible clinical outcome.
Evaluation of Macular Perfusion Analyzed by Optical Coherence Tomography Angiography after Uncomplicated Phacoemulsification
Authors: Abdelmoniem Alaa M , Gaafar Ayman A , Rashed Hazem O , Gharieb Hesham M 
Published: November 2024

Abstract

Background
Age related cataract is one of the commonest causes of diminution of vision worldwide. Phacoemulsification is one of the most common surgical procedures in the world1. Changes in arterial blood pressure, position of blood vessels, venous return of blood and CO2 levels all influence eye perfusion during cataract surgery. The exact impact of phacoemulsification on macular perfusion is unknown2&3.

Purpose
To investigate the changes of macular perfusion parameters after uncomplicated phacoemulsification using an optical coherence tomography angiography (OCT-A).

Subjects and Methods
Thirty eyes of 30 cataractous patients, who had uneventful phacoemulsification with implantation of IOL in the bag, were enrolled in this cohort study. Participants underwent a complete ophthalmologic assessment and measurement of macular perfusion parameters using optical coherence tomography angiography preoperatively and one week, one month, and three months postoperatively.

Results
There was statistically significant increase in the level of parafoveal retinal thickness and perifoveal retinal thickness in postoperative visits than preoperative visits. We have also found statistically significant increase in the level of grid central vessel density in both superficial and deep capillary plexuses in postoperative visits than preoperative visits.

Conclusion
Phacoemulsification positively increases retinal thickness particularly at parafovea and increases vascularity in the center of fovea which makes phacoemulsification beneficial even beyond visual restoration.
Operative versus Conservative Management of First-Time Anterior Glenohumeral Dislocation, A Systematic Review and Meta Analysis
Authors: Sobhy Ahmed Mohamed Hassan , Fakhry Ebeid Wessam Eldin , Dardeer Abdelrahman Mansy Ahmed Abdelhameed 
Published: November 2024

Abstract

Background
Traumatic Anterior Shoulder Instability is quite common especially in young males and high demand athletes. Management of first-time anterior shoulder dislocation remains controversial, with no consensus on whether arthroscopic stabilization or only shoulder immobilization should be offered to these patients.

Aim of the Work
To systematically review the existing literature to compare long-term results after operative stabilization and conservative primary treatment following first-time anterior shoulder dislocation, regarding recurrent instability and redislocation rates as a primary outcome, and secondary clinical outcome parameters like functional shoulder scores.

Patients and Methods
A total of 5 studies met our inclusion criteria for this systematic review and meta-analysis, performed to identify and analyze level 1 randomized controlled studies comparing the outcomes of arthroscopic stabilization versus conservative management in the form of immobilization for the treatment of primary anterior shoulder dislocation. Patients with soft tissue injury alone as well as those with additional minor bony lesions (Hill-Sachs, Bankart) were included. Recurrent instability and functional outcome were evaluated.

Results
Our results show that in young patients, arthroscopic Bankart repair after the first episode of ASD significantly reduced the risk of recurrent instability and decreased the need for a future stabilization procedure, but did not seem to significantly affect functional outcome, when compared with patients treated non-operatively with immobilization.

Conclusion
This review and meta-analysis shows that in patients younger than 40 years, arthroscopic Bankart repair after the first episode of ASD significantly reduced the risk of recurrent instability and decreased the need for a future stabilization procedure when compared with patients treated non- operatively with immobilization.