bluuebunny/crossref_metadata_2025_split huggingface dataset:
Costs of Community-Based Viral Hepatitis Screening in Cameroon Using Point-of-Care Technologies
Authors: Tazinkeng Nkengeh N , Mohareb Amir M , Asombang Akwi W , Hyle Emily P 
Published: July 2024

Abstract
This cost analysis of a community-based viral hepatitis screening program in Cameroon found an investment of $3.52 per person screened, $50.63 per new diagnosis of hepatitis B, $159.45 per new diagnosis of hepatitis C, and $47.97 per new diagnosis of either hepatitis B or C.
Comparison of Analgesic Efficacy between Bupivacaine with Dexamethasone versus Bupivacaine in Caudal Block for Pediatric Patients Undergoing Lower Abdominal Surgeries
Authors: GadAlla Raouf Ramzy , Hussien Noha Sayed , Armanious Simon Halim , Fawaz Mariam Momtaz , Younan Younan Sayed 
Published: July 2024

Abstract

Background
Caudal analgesia is one of the most popular regional blocks in paediatric patients undergoing lower abdominal surgeries but with the drawback of short duration of action after single shot local anaesthetic injection. We evaluated whether caudal dexamethasone as an adjuvant to the Bupivacaine improves analgesic efficacy after paediatric lower abdominal surgeries.

Aim of the Study
The current study is conducted to evaluate the analgesic effect of dexamethasone when given caudally as an adjuvant to bupivacaine for children undergoing lower abdominal surgeries eg: open inguinal hernia repair, hypospidius, orchidopexy and circumcision surgeries.

Methods
Totally 60 patients of 1–3 years age group, American Society of Anaesthesiologists physical status I and II undergoing elective lower abdominal surgeries were randomly allocated to two groups in double-blind manner. Group B (the control group) received 1 ml/kg of 0.25% bupivacaine caudally for lower abdominal surgeries and 0.5 ml/kg for anal and penile surgeries and Group BD received 1 ml/kg of 0.25% bupivacaine for lower abdominal surgeries and 0.5 ml/kg for anal and penile surgeries, in which 0.1 mg/kg dexamethasone was added for caudal analgesia. Post operative pain by FLACC scale (faces, legs, activity, cry and consolability tool score), rescue analgesic requirement and adverse effects were noted for 24 h.

Results
Results were statistically analysed using KRUSKAL-WALLIS TEST. Pain scores measured at 4,8 and 12h post-operative, were lower in Group BD as compared to Group B Mean duration of analgesia in Group BD 1026±139,8 min and in Group B was 465,6± 79,2 min with P = 0.001. Rescue analgesic requirement was more in Group B as compared to Group BD. Adverse effects after surgery were comparable between the two groups.

Conclusion
Caudal dexamethasone added to bupivacaine is a good alternative to prolong post-operative analgesia with less pain score compared to caudal bupivacaine alone.
Comparative Study between Modified Pectoral Nerve Block versus Serratus Block for Analgesia For Modified Radical Mastectomy
Authors: Eldin Abdelhamid Amr Essam , Eldin El Serwi Heba Bahaa , Abdelaziz Noha Mohamed , Mohamed Abdelrahman Gamal 
Published: July 2024

Abstract

Background
One of the main objectives of anesthesia is to alleviate the patient’s pain and agony, by ensuring the performance of surgical procedures without any discomfort. Elimination of postoperative pain is indispensable due to the central, peripheral and immunological stress response to tissue injury. So there is a need for extended analgesia without any side effects to achieve this goal.

Objective
To assess the analgesic efficiency and safety of both Modified Pectoral Nerve Block versus Serratus Block in cases of modified radical mastectomy (MRM). The duration of analgesia and effect on hemodynamic parameters were evaluated. Moreover, undesirable side effects were studied.

Patients and Methods
The purpose of this study was to evaluate the effect of both PECS II block versus and Serratus anterior block in patients undergoing modified radical mastectomy surgery. The duration of analgesia and effect on hemodynamics parameters were evaluated. Moreover, undesirable side effects were studied. forty patients were randomly allocated into two equal groups (20 patients): group (A) and group (B). Group (A): received a PECSII block with 30 mL of bupivacaine 0.25%. Group(B): received a serratus anterior plane block (SAPB) using the same volume of 30 ml bupivacaine 0.25%.

Results
This study demonstrated that PECSII and serratus blocks have comparable analgesic properties in patients undergoing modified radical mastectomy. Both blocks were associated with reduced postoperative pain intensity and morphine consumption, intraoperative fentanyl requirement, and prolonged analgesia. The two blocks were associated with hemodynamic stability and absence of major complications characterizes both blocks.

Conclusion
This study confirms that PECSII and serratus blocks provide similarly adequate analgesia following modified radical mastectomy.
A Comparative Study between Fascia Iliaca Block and Femoral Nerve Block for Postoperative Analgesia after Intertrochanteric Fracture Surgery
Authors: El Deen Mohammed Ahmed Emad , El Kabarity Reem Hamdy , Khamis Ahmed Mohammed , Sedky Kareem Ahmed 
Published: July 2024

Abstract

Background
Intertrochanteric fracture surgery is a common orthopedic procedure worldwide, pain may be severe, and the patients generally require a significant amount of opioid-based analgesics after such procedures. Peripheral nerve blocks offer effective analgesia and decrease the need for opioids, thereby reducing the complications associated with the use of this class of drug. Pain management regimens following Intertrochanteric fracture surgery include oral analgesics, periarticular injection, peripheral nerve blocks (PNBs), and intravenous patient- controlled analgesia (PCA).

Objective
To compare the analgesic efficacy and functional recovery of Fascia iliaca block and FNB in patients who have undergone Hip surgery.

Methods
This prospective randomized clinical trial study was conducted in Ain Shams University hospital after approval of the anesthesia department and the local ethics and research committee over 6 months and after obtaining a written informed consent. Sixty patients underwent Intertrochanteric fracture surgery under spinal anaesthesia regarding postoperative pain and early ambulation were included in the study their ages range between 40 to 75 years old and classified as ASA I and II. The patients were randomly divided using computer generated randomization into two groups 30 patients in each (n = 30).

Results
The two groups were compared as regard pain control post operatively. Numerical rating scale (NRS) was used to assess pain post operatively and used at regular interval (PACU, After 15min., After 30min., After 45min., After 1 hr., After 1.5 hrs., After 2 hrs., After 4 hrs., After 6 hrs., After 8 hrs., After 10 hrs., After 12 hrs., After 14 hrs., After 16 hrs., After 18 hrs., After 20 hrs., After 22 hrs. and After 24 hrs.). And there is no significant difference between two groups, with p- value (p &gt; 0.05 NS). As regard to total dose of narcotics used in each group, there is no difference in postoperative nalbuphine consumption. The two groups are compared as regard to quadriceps weakness, onset of ambulation and there was a significant difference between two groups.

Conclusion
Fascia iliaca block is more effective than Femoral Nerve Block in in patient satisfaction for post-operative analgesia and equally effective with femoral nerve block in post-operative ambulation after Intertrochanteric fracture surgery.
Ticagrelor versus Clopidogrel in Prevention of No Reflow after 1ry PCI in Diabetic Patients with STEMI
Authors: Khalil Elshawa Mohamed Gamal AbdElzaher , AbdElmonaem Moustafa Mohamed , Hassan Mohamed Atef Hamza , Hamid Galal Wagdy Abdel 
Published: July 2024

Abstract

Background
Adequacy of coronary flow can be judged upon using several methods like TIMI Grade and myocardial blush grade. No-reflow phenomenon, defined as incomplete reperfusion at the microvascular level despite adequate patency of the occluded artery, remains an important limitation of primary percutaneous intervention in STEMI patients nowadays. We aim in this study to investigate the relationship between the antiplatelet loading dose whether to be Ticagrelor or Clopidogrel and post intervention coronary flow, bleeding risk in these patients.

Aim of the Work
To compare between the effects of preoperative loading dose of Ticagrelor and clopidogrel in Diabetic STEMI patients undergoing primary percutaneous coronary intervention regarding prevention of no reflow, Instent thrombosis and short term bleeding risk. Myocardial reperfusion was judged upon using TIMI Grade and myocardial blush grade.

Patients and Methods
a single center prospective randomized controlled trial based at the coronary care units in Ain shams university hospitals. The study included Three hundred Diabetic patients presenting to Ain shams university hospitals diagnosed with STEMI in the ER fulfilling the inclusion criteria were randomized to receive Ticagrelor (150 patients) or receiving clopidogrel (150 patients)

Results
As regard TIMI flow there was statistically highly significant highly significant difference between two studied groups with P value 0.000 where in group A 64 % of patients developed TIMI III flow, 22.7 % with TIMI II flow, 12.7% with TIMI I and 0.7% with TIMI 0 While in group B 86% of patients developed TIMI III flow, 9.3% of them developed TIMI II, 3.3 % developed TIMI I flow and 1.3 % developed TIMI 0. As regard MBG there was statistically highly significant difference between two groups with P value 0.00 where in group A where percentage of patients with MBG grades 0,1,2 and 3 were 4%, 16 %,18 % and 62 % respectively while in group B percentage of patients with MBG grades 0,1,2 and 3 were 1.3 %, 3.3 %, 9.3 % and 86 % respectively. As regard echo EF, there was statistically significant difference between two groups with P value 0.036 where mean EF in patients with group A was 40.50 ± 7.93 while the mean EF in patients with group B was 42.55 ± 8.88 .

Conclusion
Ticagrelor loading before primary PCI resulted in improved post-procedural TIMI flow. It also increased the post-procedural MBG. This resulted in a significant increase in the number of patients having more post-procedural Ejection fraction as measured by modified Simpson’s method. However, it did not decrease incidence of in-hospital MACE. Also there was no significant increase in risk of major nor minor bleeding in both young and elderly patients.
Meta-Analysis of Surgical Treatment versus Sclerotherapy for Management Of Branchial Arch Lesions
Authors: EL Samny Talaat Aly , Sobhy Tamer Shoukry , Mohammed Marawan khairi Mahmoud , Abd Elaty Ahmed Mohamed Kamel 
Published: July 2024

Abstract

Background
Branchial arch lesions (BALS) are uncommon congenital malformations presenting mainly in first 2 decades with neck cysts, sinuses, fistulas, recurrent infections and have low potential to turn malignant. Surgical management of these lesions can be associated with significant risk of complications and recurrence. Sclerotherapy has been described as effective and less invasive alternative option.

Aim of the Study
is to summarize current available evidence regarding effectiveness and safety of surgery and sclerotherapy as two modalities of treatment for BALS.

Methods
A systematic review for all interventional studies on management of (BALS) was conducted in multiple medical databases from its inception till March 2021 with inclusion of all studies reporting on either surgical management or sclerotherapy for BALS in humans and reported effectiveness or safety outcomes. Diagnostic and review articles, single case reports and non-human studies were excluded. Proportional meta-analyses were utilized where there is only uncontrolled studies available reporting on outcomes. Assessment of quality was done with use of validated tool relevant to design of primary studies included and risk of bias of studies was assessed statistically. PRISMA Guidelines were followed in reporting of the study.

Results
A total of 525 studies were retrieved of which only 25 were eligible for inclusion. All included studies were uncontrolled case series; 18 reported on surgery and 7 reported on sclerotherapy The overall quality of included studies were fair to good according to NIH validated tool. Meta-analyses of surgical studies for BALS showed success rate of complete excision of 90%,96%,96% and 98% for first, second, third and fourth branchial arch lesions respectively with complications rates of 19.7%,5%,24% for first, second and third arch lesions. The rates of recurrence were 11.2%,2%,5%,1% for first to fourth arch lesions in order. The corresponding success rates of completed resolution for sclerotherapy were 86% with complications rates of 8% all of which were minor complications. There were no recurrences but recognized incomplete resolution.

Conclusion
Both surgery and sclerotherapy have satisfactory success in terms of complete excision/resolution of BALS. The risks of complications howeverseem to be more significant with surgical management however no controlled studies were available to allow for definitive conclusions. Further studies with standardized diagnostic criteria and treatment techniquesare needed to allow for prioritizing treatment lines based on conclusive evidence.
Brain-Derived Neurotrophic Factor as a Potential Diagnostic Marker in Minimal Hepatic Encephalopathy
Authors: Bayoumi Essam Mohamed , Sabry Mohamed Manal , Saad Mohamed Ahmed , Abdelnaeem Amin Lobna Wafik 
Published: July 2024

Abstract

Background
Based on the etiology, liver cirrhosis is sub-classified into viral hepatitis (hepatitis B, C, and D), due to toxins (alcohol and drugs), autoimmune hepatitis, Cholestatic (primary biliary cholangitis, and primary sclerosing cholangitis), vascular (Budd-Chiari syndrome, sinusoidal obstruction syndrome, and cardiac cirrhosis), and metabolic causes (hemochromatosis, NASH, Wilson disease, alpha-1 antitrypsin deficiency, cryptogenic cirrhosis).

Aim of the Work
The aim of the current study is to detect Minimal Hepatic Encephalopathy (MHE) among cirrhotic patients of Child C with no or clinically manifest encephalopathy using Brain-Derived Neurotrophic Factor (BDNF) and study the diagnostic value of BDNF serum marker versus Psychometric Hepatic Encephalopathy Score (PHES) in detecting MHE.

Patients and Methods
90 patients were enrolled into a clinical cross-sectional study. All patients gave informed written consent. Patients are divided equally into 3 groups, 30 patients each. Patients are either in-patient or out-patients in Ain shams University Hospitals. Group 1 The Examined Group (EG): includes 30 patients diagnosed as hepatitis C, cirrhotic, Child class C with no overt or clinically manifest encephalopathy. Group 2 The Hepatic Encephalopathy Group (HEG): includes 30 patients diagnosed as hepatitis C, cirrhotic, Child class C with overt or clinically manifest encephalopathy. Group 3 The Control Group (CG): includes 30 healthy individuals (volunteers).

Results
In the present study among the whole sample (n = 90), there was a significant positive correlation between PHES score & BDNF serum level with Hb, platelet count and albumin. While, there was a significant negative correlation between PHES score and BDNF serum level with AST, ALT, total bilirubin, direct bilirubin, INR and Child’s Score. On the other hand, Stawicka et al. 2021, reported that BDNF had a negative correlation with bilirubin (R = –0.35, p = 0.005) and international normalized ratio (INR) (R = –0.37, p = 0.003), and positive with platelets (R = 0.36, p = 0.004), while no associations with age, sex, body mass index (BMI), waist-hip ratio (WHR), creatinine and ammonia.

Conclusion
MHE constitutes a significant medical problem in a common patient population. Unfortunately, it is often underdiagnosed, likely related to the notion that testing is time consuming requiring highly specialized personnel. Additionally, the term ‘MHE’ may create the impression that this condition has limited impact on patient’s wellbeing; however, it has been shown that MHE has clinical implications on the patient as well as public safety concerns. Diagnosing and treating MHE is difficult owing to the subclinical nature of the disease. The use of Psychometric Hepatic Encephalopathy Score (PHES) and Brain-Derived Neurotrophic Factor could be of great help in early detection of the condition and to give suitable preventive treatment.
Diagnostic Role of Non-Invasive Risk Scores in Prediction of Simple Steatosis versus Non-Alcoholic Steatohepatitis
Authors: Awad Emad Ahmed , Ali-Eldin Zainab Ahmed , Allam Ahmed Samir , Mahmoud Maher Ibrahem 
Published: July 2024

Abstract

Background
Non-alcoholic fatty liver disease (NAFLD) is currently considered one of the most common liver diseases in the Western world. NAFLD includes a spectrum of diseases from simple fatty liver disease, to non-alcoholic steatohepatitis (NASH), liver cirrhosis and hepatocellular carcinoma (HCC). NASH, the critical stage in NAFLD progression, is the only bridge between NAFLD and liver cirrhosis, and its persistent existence has become one of the leading causes of liver cirrhosis and even HCC.

Aim of the Work
To assess the value of non-invasive risk scores in differentiation between simple steatosis and NASH

Patients and Methods
This was prospective cohort study, conducted Internal Medicine and Gastroenterology outpatient clinics and ward in Ain Shams University Hospitals, on 60 patients with NAFLD divided into 2 groups: (Group I): Patients with normal liver enzymes, (Group II): Patients with persistant elevation of liver enzymes, during a period of 6 months.

Results
There was statistically insignificant difference between the two studied groups and sex and age. There were 12 (40%) of the group I were males and 18 (60.0%) were females. There were 16(53.3%) of the group II were males and 14(46.7%) were females. The mean age of group I was 40.63 ± 10.53 SD with range (25.0 – 59.0). The mean age of group II was 40.83 ± 9.06SD with range (27.0 – 54.0). There was statistically significant difference between the two studied groups and weight, BMI and waist circumference. There was statistically insignificant difference between the two studied groups and height, DM and HTN. There was statistically significant difference between the two studied groups and ALT, AST, GGT, ALP, ALB and Platelets. There was statistically significant difference between the two studied groups and TC, HDL, LDL, TG and AST/ALT ratio. There was statistically insignificant difference between the two studied groups and FBG. There was statistically significant difference between the two studied groups and FLI, NFS, BARD, APRI, FIB-4 and Fibrosis score. There was statistically significant difference between the two studied groups and Ultrasound (Size, Findings and Fibrosis score). The mean size in group I was 10.03 ± 1.56 SD with range (8.0 – 12.0). The mean size in group II was 13.63 ± 1.22SD with range (12.0 – 16.0).

Conclusion
A combination of Fibroscan, Fib-4, NFS, BARD and APRI provides a valuable non- invasive method in diagnosis of NASH patients, and this can eliminate the need for liver biopsy in patients without clear indication, BMI, platelet count, HDL cholesterol level, ALT level, and the AST/ALT ratio were independent predictors of NAFLD.
Effect of Anti-Epileptic Drugs Usage on Thyroid Profile in Egyptian Epileptic Children
Authors: Kirolos Bichara Amira Rafik , Abou Shady Eman Moenes , Mohamed Ali Nada Maha Ali , El Khayat Naglaa Mohamed , El-Din Ahmed Nahed Salah 
Published: July 2024

Abstract

Background
AEDs Has been associated with disturbances in thyroid functions. This was studied in adults but there is contradictory data in children especiall newer AEDs.

Objective
This study aims to compare the effects of conventional and newer AEDs whether mono or polytherapy on thyroid profile in epileptic children.

Results
This study included 155 children with epilepsy (54.84 % euthyroid, 31.61% hypothyroid, 9.68% subclinical hypothyroid and 3.87 % subclinical hypothyroid) and 78 healthy controls. Epileptic children compliant on AEDS either mono-therapy or poly-therapy are associated with a statistically significant thyroid profile abnormalities (hypothyroidism, sub-clinical hypothyroidism or sub-clinical hyperthyroidism). There was no statistically significant difference between poly-therapy and mono-therapy. Carbamazepine had a statistically significant association with hypothyroidism and valproic acid had a statistically significant association with sub-clinical hypothyroidism. LEV also wa associated with significat thyroid dysfunction. There was no statistically significant difference between those on two AEDS those on three AEDS and those on four or five AEDS.

Conclusion
AEDs whether older or newer generations can effect thyroid profile. Anti –epileptic drugs whether conventional or new ones are associated with hypothyroidism, sub-clinical hypothyroidism, sub- clinical hyperthyroidism.
The Correlation between Body Mass Index and Intraocular pressure, Retinal Nerve Fiber Layer Thickness and Visual Field
Authors: Hassan Rana M , El-Shazly Amany Abd El-Fattah , Farweez Yousra A , Karim Marwa A 
Published: July 2024

Abstract

Background
Obesity has become a world-wide medical epidemic. it constitutes an important risk for several eye diseases like cataract, diabetic retinopathy, age related macular degeneration (AMD) and glaucoma.Body mass index (BMI) is one of the most specific and objective measurement to define obesity. Obesity has recently been reported to be negatively associated with visual acuity, but the ocular conditions underlying this association and the potential implications are unclear. Amongst different eye diseases, obesity has been associated with cataract, age-related maculopathy, diabetic retinopathy, and glaucoma.

Purpose
To investigate the relationship between BMI and IOP and correlate it with changes in RNFL thickness and visual field.

Materials and Methods
60 participants divided into three groups (normal, overweight, and obese) according to BMI, were included in this Cross-Sectional Study (pilot study). Participants underwent a complete ophthalmologic assessment, measurement of RNFL thickness and ganglion cell complex (GCC) thickness using SD-OCT, IOP with Goldmann applanation tonometry (GAT) and visual field analysis using Humphrey field analyser.

Results
IOP was significantly higher in obese group than those in healthy weight and overweight group. Also, IOP was statistically significant higher in overweight group compared with those healthy weight group. There were no significant differences between the three groups in average, superior, inferior, nasal, and temporal RNFL thicknesses or in GCC thickness. Yet, GCC thickness in the obese group showed significant negative correlation with BMI.There were no significant differences between the three groups in MD, and VFI.

Conclusion
IOP was variable according to the degree of obesity with incremental pattern with advance of BMI. BMI of overweight group had no correlation with IOP, average, superior, inferior, nasal, and temporal RNFL thicknesses. While BMI of obese group showed a significant positive correlation with IOP and negative correlation with GCC thickness.