bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological Study of Leprosy in Elqalaah Dermatology and Leprosy Clinic
Authors: Hussein Abdelhameid Engy Mansour , Sallam Mohammed Abdelnaeem , El- Khateeb Ekramy Ahmed 
Published: July 2024

Abstract

Background
Leprosy is a chronic, infectious disease caused by Mycobacterium leprae. It mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes. Nerve damage may result in lack of ability to feel pain, which can lead to loss of parts of a person's extremities from repeated injuries or infection due to unnoticed wounds. Egypt is one of the first countries in the region to achieve the elimination target at the national level as early as 1994, However Leprosy is still endemic in certain foci in Egypt. Thus, our study aims to evaluate the epidemiology of leprosy in Elqalaah leprosy clinic in Cairo over the last decade to support the current national control program of leprosy with updated data.

Objective
This study presents an analysis of pattern of new cases of leprosy detected annually from 2009 to 2020 in Elqalaah Dermatology and leprosy clinic in Cairo as the new-case detection rate is better than prevalence as an indicator of disease trends.

Methods and Material
Data about patients with newly diagnosed leprosy were collected from Elqalaah dermatology and leprosy clinic registry, the main referral center in Cairo governorate. Case detection rates (CDR) were calculated for each year by dividing the newly diagnosed cases by mid-year populations for the same year.

Results
504 patients were newly diagnosed between 2009 and 2020. The mean age of patients at diagnosis was 38.16 years, 64.5% were males, and 5.4% were children below 14 years of age. The new case detection rate ranged from 0.66/100,000 population in 2009 to 0.12 /100,000 population in 2020. 82.5% were classified as multibacillary. 75.6% were detected by notification method, and 82.5% of patients completed their treatment course. Macules was the most common clinical finding and was found in 67.7% of patients. 18.5% of cases had previous history of contact with other leprosy patient. 13.1% and 2.4% suffered type one and type two leprae reactions respectively. 11.9% of cases had grade two hand disabilities, 6.7% had grade two feet disabilities and 1.8% had grade two eye disabilities.

Conclusions
The new case detection rate is acceptable compared to the global level and there was a decline in the number of cases throughout the years of the study, however community- based research should be encouraged and leprosy trends over years from different regions need to be reported to know the actual status of leprosy in different regions of country and continued surveillance of patients and their contacts is required to detect relapses and undiagnosed cases.
Fractional Ablative Carbon Dioxide Laser-Assisted Photodynamic Therapy for keloids: Clinical, Histopathological and Immunohistochemical Evaluation
Authors: El Tayeb Nasser Nada Mohamed , El Samah May Hussein , El Fattah Nermeen Samy Abd , El Badawy Nafissa Amin 
Published: July 2024

Abstract

Background
Keloids present a therapeutic challenge due to lack of satisfactory treatment and high rate of recurrence. Various treatment modalities exist, including intralesional steroids, photodynamic therapy (PDT), lasers and different combinations have been used to reach better results.

Aim
To study whether fractional ablative CO2-assisted delivery of Methylene blue-PDT is an effective method of treatment of keloids.

Methods
twenty patients with untreated keloids have been treated with 3 monthly sessions of fractional CO2 laser and methylene blue PDT. In the first session debulking of the keloid’s height by at least 50% with ablative CO2 was performed. Patients were photographed and assessed before treatment and 2 months after last session, clinically using modified Vancouver Scar Scale (mVSS) & patient and observer scar assessment scale (POSAS), histopathologically by H&E, Masson trichrome and immunohistochemically by TGF-b.

Results
total score for mVSS dropped from 8.25 ± 2.489 to 6.45 ± 2.8 (p = 0.013) after treatment, with a percentage change of -18.6 ± 39.6. Also, POSAS (observer) decreasaed from 26.90 ± 6.545 to 18.75 ± 8.045 (p = 0.001). POSAS (patient) decreased from 27.40 ± 6.644 to 19.05 ± 7.722 (p = 0.0001) Histopathologically, collagen improved from 3.45 ± 1.05to 2.65 ± 0.875. The TGFb staining increased post treatment but not significantly.

Conclusions
clinical and histopathological improvement was seen after MB-PDT but further controlled studies are needed to compare its effectiveness with other established modalities. Also compare results of different parameters of fractional CO2-PDT, more treatment sessions and study the long term follow up results.
A Meta Analysis of Endoscopic Surgical Management of Choanal Atresia with and without Stent
Authors: Mabrouk Ashraf AbdelZaher , Mahmoud Mohammad Salah , Kamel Fadel Michael Mounir , Mohamed Gaafar Karim Mohamed 
Published: July 2024

Abstract

Background
Congenital choanal atresia is a rare abnormality, affecting approximately 1 in 7000–8000 newborns, with a female predominance. In congenital choanal atresia, the widened vomer fuses with the atretic plate, resulting in an hourglass configuration of the nasopharynx and the choanal region.

Materials and Methods
This meta analysis included 17 studies all were published between 2016 and 2021. Two different techniques, endoscopic management with and without stents, this study demonstrated success with no stent approach and lower rate of re stenosis when compared to stent used approach, however there are some indications and benefits of using stents.

Results
For our knowledge this is the second systematic review and metaanalysis to report the pooled success of endoscopic repair of choanal atresia with and without the use of nasal stents. Analysis of 5 studies that included 142 patients who were not stented demonstrated that the weighted pooled proportion of successful surgery was higher and significantly different when compared with three studies that evaluated 57 patients who were stented 86% (79%, 92%) vs 61% (40%, 81%). From an analysis of nine comparative studies including 405 patients Overall odds ratio (95% CI) = 3.56 (2.10, 6.05) with unimportant heterogeneity across studies (I-squared = 37%, Cochrane Q p = 0.12) favoring no stenting over stenting.

Conclusion
Success rates for management without stents is higher than using stents. The use of nasal stents may be associated with more frequent and more severe complications. Perioperative adjuncts such as nasal stenting should be considered in the context of the individual patient and surgeon preference. If the surgeon decides to stent, a duration of 1 week or shorter may be associated with better surgical outcomes; however, the evidence is limited.
Different Recent Scoring Systems for Better Diagnosis of Acute Appendicitis
Authors: Hanna Hanna H , Abd El-Moaty Karim F , Abd El-Maksoud Ibrahim M , Fatoh Mohammed Essam M 
Published: July 2024

Abstract

Background
Acute appendicitis is one of the most common surgical emergencies, with a lifetime prevalence rate of approximately one in seven.

Aim of the Work
to compare RIPASA score, (AIR) score and Modified Alvarado Score widely and easily used scoring systems, in order to identify which one is the best in sensitivity, specificity, positive predictive value, negative predictive value and accuracy, So which one leads to the most accurate diagnosis of acute Appendicitis.

Patients and Methods
A randomized prospective study that was conducted in Ain-Shams University Hospitals. The study started in February 2022 till the number of cases is fulfilled. 50 patients presented with RT iliac fossa tenderness. Each patient was scored by the three scoring systems using history, examination, clinical labs.

Results
66.0% of cases were positive confirmed histology and (34.0%) cases were negative confirmed histology. There were highly statistically significant difference between Negative Confirmed histology and Positive Confirmed histology regarding RIPASA score, (AIR) score and Modified Alvarado Score. In this study, receiver operating characteristic curve (ROC) shows that the best cut off point of Modified Alvarado Score to detect Positive Modified Alvarado Score group was found &gt;5 * with sensitivity of 87.88%, specificity of 64.71%, PPV of 82.9%, NPV of 73.3% and total accuracy of 77.0%.

Conclusion
the Appendicitis Inflammatory Response score and Raja Isteri Pengiran Anak Saleha Appendicitis score have high discriminating powers and outperform the Modified Alvarado score. They could aid in selecting patients who require timely surgery or those who require further evaluation. Both these scores have the potential to turn out into scoring systems of choice if future research can substantiate our study findings.
Laparoscopic versus Open Appendectomy in Appendicitis Cases (Retrospective Comparative Study)
Authors: Gad Khaled Hussein , Mahmoud Al-Hefny Amr Mohammed , Abd-Elmonem Ayman Hossam Eldin , Yousef Kereet Aliaa Mahmoud 
Published: July 2024

Abstract

Background
Appendectomy is one of the most commonly performed surgeries worldwide. It is commonly done by conventional open method but with progress of laparoscopic surgical procedures, laparoscopic appendectomy is also practiced nowadays. Ever since its initial description by Semm in 1983, laparoscopic appendectomy has struggled to prove its superiority over the open technique. The concept of minimal surgical trauma, resulting in significantly shorter hospital stay, less postoperative pain, faster return to daily activities has made laparoscopic surgery for acute appendicitis very attractive.

Objective
To compare the intraoperative and post operative outcomes of laparoscopic versus open appendectomies for Appendicitis cases.

Patients and Methods
This study was done from April 2022 to September 2022 on 60 patients with clinical diagnosis of acute appendicitis admitted in surgical wards of Aldemerdash hospital. The patients were selected by random sampling technique. All the patients were followed every day in post operative period till they were discharged and then later followed for a period of 4 weeks in and out patients department.

Results
In the study, 8 patients in open group (26.7%) and 4 patients in laparoscopic group (13.3%) have post op fever. In the study, 8 patients in open group (26.7%) and 1 patients in laparoscopic group(3.3%) have post op wound infection. The difference was significant (p &lt; 0.01) In the study, The mean hospital stay score was 1.77 ± 0.728 days in the laparoscopic group and 7.73 ±1.363 days in the open group. The difference was significant (p &lt; 0.0001). In the study, the mean score return to work was 9.6 days in laparoscopic and 17.67 days in the open group. The parameter difference was significant p &lt; 0.0001 In the laparoscopic group, 26 (86.7%) patients were satisfied with cosmetic benefit, 4 (13.3%) patients were equivocally satisfied, 0 patients were unsatisfied.

Conclusion
We conclude that laparoscopic appendectomy is better than open appendectomy in respect to post operative pain, post operative complications, duration of the hospital stay, return to the work, cosmetic benefit. Duration of time of surgery is higher in laparoscopic compared to open appendectomy.
Laparoscopic versus Open Appendectomy in Appendicitis Cases (Retrospective Comparative Study)
Authors: Gad Khaled Hussein , Mahmoud Al-Hefny Amr Mohammed , Eldin Abd- Elmonem Ayman Hossam , Yousef Kereet Aliaa Mahmoud 
Published: July 2024

Abstract

Background
Appendectomy is one of the most commonly performed surgeries worldwide. It is commonly done by conventional open method but with progress of laparoscopic surgical procedures, laparoscopic appendectomy is also practiced nowadays. Ever since its initial description by Semm in 1983, laparoscopic appendectomy has struggled to prove its superiority over the open technique. The concept of minimal surgical trauma, resulting in significantly shorter hospital stay, less postoperative pain, faster return to daily activities has made laparoscopic surgery for acute appendicitis very attractive

Objective
To compare the intraoperative and post operative outcomes of laparoscopic versus open appendectomies for Appendicitis cases.

Patients and Methods
This study was done from April 2022 to September 2022 on 60 patients with clinical diagnosis of acute appendicitis admitted in surgical wards of Aldemerdash hospital. The patients were selected by random sampling technique. All the patients were followed every day in post operative period till they were discharged and then later followed for a period of 4 weeks in and out patients department.

Results
In the study, 8 patients in open group (26.7%) and 4 patients in laparoscopic group (13.3%) have post op fever. In the study, 8 patients in open group (26.7%) and 1 patients in laparoscopic group(3.3%) have post op wound infection. The difference was significant (p &lt; 0.01) In the study, The mean hospital stay score was 1.77 ±0.728 days in the laparoscopic group and 7.73 ±1.363 days in the open group. The difference was significant (p &lt; 0.0001). In the study, the mean score return to work was 9.6 days in laparoscopic and 17.67 days in the open group. The parameter difference was significant p &lt; 0.0001 In the laparoscopic group, 26 (86.7%) patients were satisfied with cosmetic benefit, 4 (13.3%) patients were equivocally satisfied, 0 patients were unsatisfied.

Conclusion
We conclude that laparoscopic appendectomy is better than open appendectomy in respect to post operative pain, post operative complications, duration of the hospital stay, return to the work, cosmetic benefit. Duration of time of surgery is higher in laparoscopic compared to open appendectomy.
Serial Transverse Enteroplasty (STEP) versus Longitudinal Intestinal Lengthening and Tailoring (LILT): Systematic Review and Meta-Analysis of Outcomes and Complications
Authors: Khalil Ahmed Ibrahim , Abbass Ahmed Adel , El Monaem Ayman Hossam El din Abd , Yousef Salem Ahmed Atef Abdelghani 
Published: July 2024

Abstract

Background
The prevalence of SBS is 3-4 per million. It occurs in about 15% of adult patients who undergo intestinal resection, with 3/4th of these cases resulting from massive intestinal resection and 1/4th from multiple sequential resections. About 70% of patients in whom SBS develops are discharged from the hospital and a similar percentage remain alive a year later. This improved survival rate has been achieved primarily by the ability to deliver long-term nutritional support.

Objective
To compare between Serial Transverse Enteroplasty (STEP) and Longitudinal Intestinal Lengthening and Tailoring (LILT) in the incidence of complications and clinical prognosis regarding morbidity and mortality in patients with Short Bowel Syndrome (SBS).

Patients and Methods
The search was carried out using the electronic national library of medicine PubMed database, Cochrane library and manual reference of articles published on serial transverse enteroplasty (STEP) versus longitudinal intestinal lengthening and tailoring (LILT) in management of patients with SBS. Conclusive search was done and duplicate studies were excluded.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available on the Internet till 2022.

Results
LILT and STEP are both valuable treatment strategies used in the management of pediatric SBS. However, currently, it is not possible to advise surgeons on accurate patient selection and to predict the result of either intervention. There is very limited published data on bowel lengthening procedure exclusively in adults. Most reported series exclusively or predominantly discuss the pediatric population with some adults included in one series and two additional single case reports.

Conclusion
Both STEP and LILT are potentially safe and effective methods for the treatment of SBS, under the conditions that the surgical techniques required have been mastered and the indications for surgery are observed. This review should be a gateway to open the scope on the field of Autologous Intestinal Reconstruction Surgeries (AIRS) and plan for a more detailed prospective studies with close monitoring of the data regarding outcomes, complications and follow up.
Causes Responsible For Failure of Fundoplication: A Meta-Analysis
Authors: Mohamed Ezz Reda Saad , Gerges Wadie Boshra , Ali Fadl Ehab Mohammed , Hanna Labib Ibrahim Wadie Labib 
Published: July 2024

Abstract

Background
GERD is a very common disease nowadays. When medications like Proton Pump Inhibitors fail, Surgery becomes the treatment of choice.

Objective
To review and study the most common causes responsible for failure of Fundoplication and development of the most common postoperative complications (recurrence of reflux, dysphagia and gas-bloat syndrome).

Patients and Methods
Types of studies Published studies about the complications of Laparoscopic Fundoplication (carried out in the period between 2000 – 2021). Types of participants Patients with clinically proven complications like GERD, belching, dysphagia or unintentional slipping after Fundoplication.

Results
A copy of each paper identified was obtained, and relevant data was Abstracted for a quantitative overview. In case of discrepancies or when the information presented in a study is unclear, Abstraction by a second reviewer was sought to resolve the discrepancy. All included articles was assessed for quality regarding methodological strength as per the 2009 Cochrane collaboration updated guidelines for systematic reviews.

Conclusion
According to our results, paraesophageal hernia in addition to, disruption and tight wrap are significant causes of failure of Nissen fundoplication.
Pedicled Descending Branch Latissimus Dorsi Mini-Flap For Breast Reconstruction: Shoulder Functional and Aesthetic Outcomes
Authors: El-Attar Usama Mohamed , Kamal Ahmed Nabil , Zaid Mohamed Hamdy , Fouad El-Shimy Mohamed Ahmed , Elsayed Moghazy Mahmoud Elsayed 
Published: July 2024

Abstract

Background
The cosmetic drawbacks of BCT are asymmetry, nipple or skin retraction, and volume loss which results in an unsatisfactory cosmetic outcome. Therefore, many volume replacement techniques were invented to counteract this. The commonest volume replacement technique for breast reconstruction is autologous LD flap in which skin paddle and subcutaneous tissue are harvested with the flap resulting in increased donor site morbidity.

Objective
To evaluate the latissimus dorsi mini-flap (LDMF) regarding the cosmetic outcomes and patient satisfaction. Moreover, it will evaluate procedure related complications and the benefit of using this procedure as a volume replacement to large breast defect after wide local excision in different breast quadrants excluding the lower inner quadrant (LIQ).

Patients and Methods
Our study was conducted on 15 patients to evaluate post-operative complications and patient satisfaction primarily. The results have demonstrated the safety of this procedure which is associated with a low rate of complications. Our study was designed to assess breast-sparing approaches using LD mini flap (LDMF) for reconstruction of the breast after wide local excision of large breast tumors that would result in otherwise unacceptable deformity.

Results
The LDMF generally is not a time-consuming technique as the average operative time was generally less than three hours. This time included the time for resection and the time waiting for frozen section results. The LDMF reconstruction was associated with considerable sensory preservation. This technique not only preserves most of the breast tissue but also, it spares us doing additional procedures such as nipple reconstruction. Avoidance the use of an implant is an additional advantage to the LDMF as this decrease the rate of infection and decrease the cost of the procedure.

Conclusion
LDMF volume replacement extends the role of breast-conserving surgery to a group of patients who are traditionally offered mastectomy. Despite the increasing use of Neoadjuvant chemotherapy, some patients have a disease that fails to respond or extensive DCIS and can, therefore, benefit from this oncoplastic technique. Frozen-section analysis of the tumor cavity is essential for surgical decision making. Our study had demonstrated the safety of this procedure which is associated with a low rate of complications. This technique has a high patient satisfaction rate wit agreeable cosmetic outcome. This technique can be used as a volume replacement to large breast defect in different breast quadrant except in lower inner quadrant which was not included in this study.
Tacker Fixation versus Suturing of Mesh in Laparoscopic Inguinal Hernia Repair
Authors: Mohamed Amer Hazem Abdelsalam , Abdelmoaty Karim Fahmy , Raslan Ibrahim Khaled , Ahmed Mostafa Ahmed Mostafa 
Published: July 2024

Abstract

Background
Laparoscopic hernia repair is more difficult technically than open surgery and there is evidence of learning curve in its performance and many complications which reported from laparoscopic procedure is due to learning curve lead to operative complications.

Objective
To compare the outcome results of the fixation of mesh by intracorporeal sutures and by tackers in TAPP hernia repair.

Patients and Methods
In our study, 30 patients were included divided on two groups, 15 for each. Group A; fixation mesh with tackers, Group B; fixation mesh with intracorporeal sutures. Both groups were compared in terms of operative technique, operative time, mesh device fixation cost, intra & post operative complications, early post operative pain within two weeks and in first month, hospital stay, restriction of physical activity and incidence of recurrence and chronic pain.

Results
We found that using Intracorporeal sutures for fixation mesh is available, cheaper and more handle than using the Tackers which are expensive and less available so it makes a laparoscopic hernia more practical and decrease need for open surgery so we avoid the complication of open surgery. Both techniques are considered safe and effective with similar rates of recurrence and chronic pain although further wider scale studies are recommended.

Conclusion
TAPP hernia is considered safe as all perioperative complications are well tolerated by patients and mostly there was no need for a second operative intervention. Mesh fixation technique did not affect long-term persistent pain. A large number of patients reported persistent pain regardless of mesh fixation technique, which emphasizes the need for preoperative information. Preoperative pain was a risk factor for persistent pain. The optimal surgical approach must be selected individually for the patient, taking into account patient age, hernia size, unilateral or bilateral, primary or recurrent status, strangulation and type of anesthesia, occupation, and leisure activities. Both techniques are effective in the management of inguinal hernia and were associated with same recurrence rate. However, due to small sample size and short follow up duration, longer- term studies are also recommended.