bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Distal Tibial Deformity Secondary to Traumatic Physeal Arrest: Systematic Review and Meta-Analysis
Authors: Hassan Fayed Mahmod Mohamed , Kamal Hisham Mohamed , Armia Amir Ashraf 
Published: July 2024

Abstract

Background
Injuries of the ankle growth plate are the second most common physeal injury of the childhood and comprises 6% of all fractures of the tibia. These injuries are typically observed among children 10 to 12 years of age, usually as Salter-Harris (SH) Type 1 and Type 2 fractures followed by Type 3 and Type 4 fractures.

Objective
To review modalities of treatment for distal tibia deformity secondary to physeal arrest post traumatic and to perform a systematic review and meta- analysis of the outcome for different methods of treatment.

Methodology
The included studies published between 2000 and 2021. Regarding the type of included studies, 8 studies (out of 10 studies) were retrospective; while 2 studies were prospective.

Results
Meta-analysis study was done on 6 studies which described Epiphysiodesis technique for distal tibial deformities secondary to post-traumatic physeal arrest; with overall number of patients (N = 215). We calculated efficacy for each technique through (Bone union ―success rate‖) and (Excellent functional outcome). We calculated safety for each technique through (Revision rate) and (Complication’s rate).

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

Conclusion
Ilizarov technique for corrections of post-traumatic physeal arrest ankle deformities showed better efficacy and safety profiles, compared to Epiphysiodesis. Which also, showed relatively good efficacy and safety especially in children with post-traumatic physeal arrest ankle deformities.
Complication Rate and Patient Satisfaction Following Bilateral Simultaneous Total Knee Arthroplasty
Authors: Elkilany Mohab Essam , Elkader Hammad Amr Abd , El Sayed Awad Mohamed , Abd El Hamid Radwan Gamal Eldeen 
Published: July 2024

Abstract

Background
Advanced knee osteoarthritis (OA) is a common clinical problem requiring knee arthroplasty. Knee Osteoarthritis can be diagnosed by X-ray. Total knee arthroplasty can be done simultaneous or staged in 2 different sessions.

Aim of the Work
To assess the results of simultaneously bilateral total knee arthroplasty as regard complications and patient satisfaction and compare to results in the literature to provide a clear guideline for proper choice of patients.

Patients and Methods
In the period between August 2018 and October 2020, a prospective cohort study was conducted in Ain Shams University Hospital in Cairo and Taiba hospital in Kuwait on 45 cases who suffered from advanced bilateral knee osteoarthritis and underwent bilateral simultaneous total knee arthroplasty.

Results
The study was conducted on a wide age group ranging from 47 to 75 years, (mean age 64.29±6.23 years). There was female predominance with 41 females with percentage 91.1% and 4 males with percentage 8.9%. Regarding patient satisfaction, the comparison of Pre- and Post-operative was 15.24±2.45, compared to 32.18±4.08 respectively, the mean difference 16.93. In comparing objective knee score by the Knee Society Scoring system, in each of Pre- and Post- operative was 58.90±6.28, compared to 82.62±5.70 respectively. Also, in Functional knee score in each of Pre- and Post-operative was 51.39±8.67, compared to 73.80±7.75 respectively. 4 patients (8.9%) had complications out of them 3 patients (6.7%) had superficial infection and 1 patient (2.2%) had acute coronary syndrome.

Conclusion
With careful preoperative patient selection bilateral Simultaneous total knee arthroplasty can be safe with low mortality and complication rates.
Treatment of Acute Acromioclavicular Joint Dislocation Using Hook Plate: A Systematic Review and Meta-Analysis and Update of Current Literature
Authors: Kamel Samy Rasmy , Fathy Hewaidy Ayman Ibrahim , Khattab Mohammed Fawzy 
Published: July 2024

Abstract

Background
the hook plate metallic device showed early promise as an alternative implant to treat unstable acromioclavicular joint dislocation injuries. The hook plate can be used to provide an indirect reduction of a distal clavicle fracture. This indirect reduction technique is useful for comminuted fractures or fractures with very small distal fragments in which conventional reduction and fixation is difficult.

Aim of the Work
to evaluate the treatment of acute acromioclavicular joint dislocation and radiographic outcomes.

Materials and Methods
Studies were considered eligible if they expressed treatment of acromioclavicular joint dislocation using the hook plate and described the patient's clinical and functional outcomes; intra-operative, post-operative complications, full-text articles were available, randomized controlled trials, including cluster RCTs, controlled (non-randomized) clinical trials or cluster trials, prospective and retrospective comparative cohort studies, and case-control or nested case-control studies. We will exclude cross-sectional studies, case series, case reports and literature not in English. All items that didn't match the above criteria were excluded.

Results
The total studies included 270 patients with average mean age 35.5 years and mean follow up 25.33 months. The Constant Murely score average 84 points (The CMS was developed for the evaluation of shoulder function with subjective and objective components) and the p value &lt;.05 that means all patients had significant improvement. Full range of motion could be achieved in the patients. Patients with restrictions of range of motion mainly showed limitations in abduction and external rotation. These limitations are most probably caused by the post-operative immobilization, which is necessary after implantation of hook plates to ensure healing of the ligament structures and avoid damage of the acromion by the hook itself. Other studies also showed restrictions of range of motion for abduction and external rotation after hook plate implantation.

Conclusion
it has a good to excellent Constant Murely score (full range of motion) that enables quick return to activities. It is useful for (Rockwood III-VI). So good clinical results can be achieved with hook plate.
Arthroscopic repair of Non Traumatic Small to Medium Sized Full Thickness Rotator Cuff Tears with and without Acromioplasty
Authors: Samy Maged Mohamed , ELdeen Abdelhamid Radwan Gamal , Haron Haithem Kamel , Mekheimer Mohamed Mohamed 
Published: July 2024

Abstract

Background
The shoulder joint has the greatest range of motion of any other joint. Pain of the shoulder joint is very common and accounts for about 16% of musculoskeletal disorders taking the third place after spine and knee. Rotator cuff disorders including degeneration or tear are most common causes of chronic shoulder pain. Causes of rotator cuff tear (RCT) still unclear and occur as a result of many factors. As degenerative changes of the rotator cuff that occur in old age increase the risk of rotator cuff tear also overhead workers and athletes considered a risk factor.

Objective
To evaluate the role of acromioplasty in arthroscopic repair of small to medium sized full thickness tear of rotator cuff according to the complication rate, the active range of motion and the function scores of the shoulder to add surgeons in deciding whether acromioplasty must be done routinely during arthroscopic repair of rotator cuff or not.

Patients and Methods
During the period between February 2019 and May 2022, A Prospective, Randomized Controlled Clinical trial was conducted in Ain Shams University hospital in Cairo. This study was designed to involve 36 cases with symptomatic small to medium sized RC tear, the patients were separated into two groups of 18. Group A comprised those applied with arthroscopic rotator cuff repair, bursectomy and antero- inferior acromioplasty. In Group B, arthroscopic rotator cuff repair was applied with bursectomy only and no acromioplasty. Each patient in this study was carefully assessed clinically by taking a detailed medical history and adequate clinical examination.

Results
There was a significant difference between the pre-operative and post-operative ASES score, WORC score and ROM but according to postoperative evaluation regarding ASES score, WORC score and ROM there was no statistically significance between the group of acromioplasty and the group of non-acromioplasty. Regarding complications, 3 cases of study population (36) cases were complicated, one case in group A (frozen shoulder) and 2 cases in group B (frozen and revision). With respect of the literature, the results were comparable to that of the literature as regard the functional outcome and complication rate.

Conclusion
The result of this study showed that there may be no need for routine application of acromioplasty during arthroscopic rotator cuff repair as it has concerns being less cost effective. We acknowledge that the cost was not assessed in our study. However, they are intuitive. Also, more long term follow up studies are required to assess the incidence of retear in rotator cuff repair without-acromioplasty as controversy is still present in the literature.
Total Knee Replacement as Primary Management in Comminuted Tibial Plateau Fracture in Elderly Patients: A Systematic Review and Meta-Analysis
Authors: Ibrahim El-Abbassi Ahmed Magdi ElSayed , Ahmed El-Sebaie Mahmoud , Zakaria Eraky Zeiad Mohamed , Khaled ElGhazawi Ahmed Mohamed 
Published: July 2024

Abstract

Background
Fracture of the tibial plateau represents approximately 8% of fractures in elderly patients. These injuries occur with an estimated incidence of 13.3 per 100,000 adults annually, with nearly a quarter of these occurring in elderly patients with concomitant osteoporosis. In young patients, the mainstay treatment for displaced tibial plateau fracture is open reduction and internal fixation (ORIF). However, in elderly patients with periarticular fracture, the combination of poor bone quality, metaphyseal bone comminution, and friable soft tissue envelope creates unique challenges to traditional ORIF.

Aim of the Work
To evaluate the perioperative complication rates and clinical outcomes in patients following TKA for primary treatment of tibial plateau fracture and to establish whether TKA can be considered a reliable primary treatment option in selected individuals.

Patients and Methods
The present systematic review will be performed in accordance with the preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search for all level I–IV evidence published articles using the online databases MEDLINE, Embase, and PubMed will be performed. The purpose of this search is to identify all eligible studies featuring perioperative complications or clinical outcomes in patients following TKA for primary treatment of tibial plateau fracture.

Results
The immediate management of acute tibial plateau fracture in elderly patients continues to be controversial. Although there is emerging evidence showing positive results for primary TKA for tibial plateau fracture, it is paramount to appreciate that performing TKA in the context of acute tibial plateau fracture is not a straightforward attempt. Many of these patients have notable loss of the articular surface, which disrupts normal anatomic references, and compromised soft tissue due to possible coexisting ligamentous injury.

Conclusion
Total knee arthroplasty for treatment of acute tibial plateau fracture is an enticing alternative to ORIF to allow early weight bearing, especially in elderly patients with poor bone quality and a friable soft tissue envelope. Our systematic review shows that functional scores are only average.
Muscle Ultrasonography in Relation to Motor Function in Children with Duchenne Muscular Dystrophy
Authors: Rihan Ahmed A , Hassanein Sahar M A , Elagouza Iman A , Sakr Hossam M , Deif-Allah Shaymaa Ahmed A M , Mohammed Maha Z R 
Published: July 2024

Abstract

Background and Aim
Duchenne muscular dystrophy (DMD) is the most common muscular dystrophy of childhood and affects 1 per 3600 male births. Electromyography and muscle biopsy were a commonly ordered invasive diagnostic procedure, used to evaluate children with weakness suspected to be caused by muscle disease. Recently, neuromuscular imaging is used as non-invasive diagnostic tool for various muscle diseases. Muscle ultrasonography is increasingly used for the diagnosis and follow up of children with DMD.

Aim of the Work
The aim of this study was to describe the pattern of ultrasonographic thigh muscles involvement, and to correlate the US findings with motor functional status.

Patients and Methods
Functional motor assessment was the functional performance protocol (GSGC score) Gait (G), Climbing stairs (S), Gower's maneuver (G), and Arising from a chair (C). Sonographic assessment of quadriceps rectus femoris muscles.

Results
Twenty-four genetically confirmed ambulatory DMD children were enrolled in this cross- sectional study. Their mean age of 7.46 ± 1.82 (4.5–11 years). The Rt and Lt Quadriceps muscles positively correlated with the age. The Rt. and Lt. Quadriceps muscle assessment significantly related to the scores for gait, stairs, chair arising, GSGC total score, time to walk 10 m, Time to rise from the floor.

Conclusion
Ultrasonography could be used as a non-invasive method to assess progressive muscle hypertrophy in boys with Duchenne muscular dystrophy. Furthermore, Quadriceps muscle US correlates with the motor functions in ambulant DMD boys below the age of 12 years.
Utility of Neonatal Pain, Agitation and Sedation Scale and Amplitude Integrated Electroencephalogram for Detection of Different Levels of Sedation in NICUs
Authors: Mohamed Basem Bahaa , Mohammed Maha Zakayria , Abd el-AalDawoud Mohamed Omar , El-Raggal Nehal Mohamed , Amin Ibrahim Mariam John 
Published: July 2024

Abstract

Background
Sedatives are essential drugs in every intensive care unit used to ensure the patient's optimal level of comfort. Avoiding conditions of over and under sedation is a challenge in a neonatal intensive care setting. To date, there are no definitions of optimal levels of sedation in neonates. Testing the hypothesis that if a combined use of Neonatal Pain, Agitation and Sedation Scale (N- PASS) and amplitude integrated electroencephalography (aEEG) score might be helpful to distinguish different levels of neonatal sedation and therefore useful in titration of the drugs used.

Aim of the Work
The primary aim of the present study is to assess Neonatal Pain, Agitation and Sedation Scale (N-PASS) and amplitude integrated electroencephalography (aEEG) in the detection of different levels of neonatal sedation.

Patients and Methods
This was prospective observational study conducted on 30 full term neonates on mechanical ventilation reciving sedation (midazolam,fentanyl). we divided our patients into two groups (lightly sedated and deeply sedated patients) according to dose of sedation which determined by the expert opinion according to the clinical condition of the patients. all patients were subjected to the following:(demographic data, clinical signs & symptoms, laboratory investigations, N-PASS and aEEG before and after sedation from march 2021 to August 2022 to evaluate N-PASS and aEEG in the detection of different levels of neonatal sedation.

Results
In our study which was conducted on 30 patients admitted to NICU at Ain shams university hospitals, our patients were of mean gestational age 38.34, all patients presented with respiratory distress, were mechanically ventilated and received sedation (midazolam, fentanyl). we divided our patients into two groups (lightly sedated patients who were 11 patients (36.7%), deeply sedated patients who were 19 patients ( 63.3% ) according to dose of sedation. There was a significant decrease of co2 level in deeply sedated patients, mean co2 after deep sedation 43.36 mmHg while mean co2 after light sedation 51.52 mmHg (p 0.034),and regarding N-PASS significant decrease in N-PASS total score after sedation (p &lt; 0.001 ),and regarding aEEG significant decrease of total burdjalov score after sedation (p &lt; 0.001 )

Conclusion
We recommend combining a clinical scoring system such as the N-PASS, with a continuous brain activity monitor such as the aEEG for assessing the level of sedation in neonates.
Cardiac Follow up of Pediatric Patients Presented with Covid-19 Cardiovascular Affection
Authors: Mahmoud El-Samman Nora Hussein , El Guindy Waleed Mohamed , El-Ganzoury Mona Mostafa , Belal Hassan Hager Mostafa 
Published: July 2024

Abstract

Background
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is typically very mild and often asymptomatic in children. A complication is the rare multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 carditis, presenting 4–6 weeks after infection as high fever, organ dysfunction, and strongly elevated markers of inflammation.

Aim of the Work
To Follow up of Pediatric Patients Presented with Covid-19 Cardiovascular Affection.

Patients and Methods
This was an analytical Prospective Cohort study conducted on 33 patients with post COVID-19 infection. all patients were subjected to the following:(demographic data, clinical signs & symptoms, laboratory investigations and Echocardiogrsphy at presentation, 1,6 weeks and 3months follow up from January 2021 to August 2021 to evaluate the short and mid- term effect of COVID-19 infection on cardiac function, and outcomes for pediatric multisystem inflammatory syndrome related to covid-19.

Results
In our study all patients fulfilled criteria of MIS-C presented with Kawasaki disease(KD)- like symptoms and gastrointestinal symptoms in addition to fever with shock or cardiac dysfunction. Our patients were presented with the following vital data: tacycardia with mean of 132.82 (18.74) beat/minute, hypotension with mean of 88.03 (14.06) (mmhg) for systolic blood pressure & mean of 49.39 (14.78) mmhg for diastolic blood pressure, spo2 mean 96.27 (2) %, high grade fever of mean 38.36(0.79). KD-like features were seen in many patients (skin rash in 66.7%, conjunctivitis in 75.8% and Cardiovascular abnormalities were seen in 100% e.g. (myocardial dysfunction, valvular regurgitation, pericardial effusion and shock. Our MIS-C patients had signs and symptoms of an inflammatory state e.g.(fever, rash, conjunctivitis and diarrhea(gastroenteritis).

Conclusion
MIS-C is a hyper-infammatory syndrome affecting multiple organs especially the heart and is triggered by SARS-CoV-2 infection. It is usually seen 2–4 weeks following infection. In our study,IVIG and steroids might have a beneficial role in MIS-C management.
Device Closure of Ventricular Septal Defect: A Retrospective Study at Pediatric Cardiac Unit, Pediatrics Hospital, Ain Shams University
Authors: Abdel Latif Doaa Shaaban , Mamdouh Nevin Mohamed , EL sayed Eman Mohamed 
Published: July 2024

Abstract

Background
The ventricular septal defect (VSD) accounts for 20% of all isolated congenital heart conditions. Nowadays, transcatheter closure is considered a feasible method of therapy for different types of VSDs.

Objective
To do a statistical analysis of VSD patients' data who underwent interventional cardiac catheterization to evaluate safety and outcome of transcatheter closure of VSDs.

Methods
This retrospective cohort study included review of files of 35 patients with VSDs who underwent interventional cardiac catheterization at the Pediatric Cardiac Catheterization Unit, Children’s Hospital, Ain Shams University during the period from first of January 2018 to the end of January 2021.Data were extracted from patients’ medical records, either through medical history, physical examination, pre- and post-intervention investigations, or procedural data.

Results
In our study, 35 VSD cases had attempts for device closure. Perimembranous VSD was present in 19 cases (54.3%), muscular VSD was present in 12 cases (34.3%), and basal muscular VSD was present in 4 cases (11.4%). Amplatzer Duct Occlude II (ADOII) was used in 17 patients (48.6%), a Muscular Amplatzer VSD device was used in 8 patients (22.9%), a PDA device was used in 8 patients (22.9%), and Amplatzer Duct Occlude I (ADOI) was attempted in 2 patients (5.7%). The most common complications in our study group were minor ones, such as mild tricuspid regurgitation, which occurred in 5 patients (14.3%), hemolysis, and blood transfusion in 1 patient (2.9%). There were no major complications such as aortic regurgitation, heart block, residual VSD, arrhythmia, device embolization, thrombus or clot at the device site, or hemolysis requiring surgical removal of the device. There was also no mortality in the study group. There was a statistically significant increase in the percentage of ADOI devices in complicated patients compared with non-complicated patients (p-value = 0.001), while no statistically significant difference was found between the two groups regarding the percentages of PDA, ADOII, and Muscular Amplatzer devices. The VSDs of all 35 patients were effectively closed, achieving a success rate 100%.

Conclusion
transcatheter closure is a safe and practical technique for VSDs with different morphologies. The outcomes of transatheter closure of VSDs done in our relatively new center were satisfactory and approximated to results of other international pediatric cardiac catheterization centers as regards complications, mortality, and success rate.
Impaired Hypoglycemia Awareness in Children and Adolescents with Type 1 Diabetes and its Association with Diabetic Autonomic Neuropathy
Authors: Matter Randa M , Elhenawy Yasmine Ibrahim , Mansour Mahmoud , Wahba Mahmoud , Waheed Marwa , Nasef Abd ELHady 
Published: July 2024

Abstract

Background
In general, hypoglycemia is more frequent among the young explaining the higher frequency of impaired awareness of hypoglycemia (IAH) among children andadolescents. Thus the aim of the current study was to assess the frequency of IAH among anEgyptian cohort of children and adolescents with type 1 diabetes and identify the possible association between impaired awareness of hypoglycemia and autonomic neuropathy.

Patients and Methods
A crosssectional study recruiting 100 patients with type 1 diabetesfor at least 6 months duration and aged less than 18 years old recruited from the Pediatric and Adolescent Diabetes Unit (PADU). Patients with other form of diabetes, cardiac disease,thyroid disease, anemia, other chronic disease, patients with intellectual disabilities or patients taking any medications were excluded from the study. The Gold and Clarke questionnaires were used to assess hypoglycemia awareness among the studied cohort.Cardiac autonomic neuropathy (CAN) was assessed using 15 minutes Holterelectrocardiography (ECG).

Results
Among the studied cohort, 42% showed IAH using theClarke’s and Gold's Questionnaires. When assessing CAN, 46% of the studied cohort showedresting tachycardia and patients with resting tachycardia showed significantly longer diseaseduration.There were no normative heart rate variability parameters values for the Egyptian children that can be used as a reference for diagnosis of cardiac autonomic neuropathy. So weused sex and age matched control group to find specific cutoff values for heart rate variabilityparameters to diagnose CAN. The results showed that the prevalence of CAN among studiedpatients was 88% and there were no significant correlation between CAN and both questionnaires score. 55.7% of CAN patients were aware while 44.3% were unaware. Thus,there were no association between impaired awareness of hypoglycemia and CAN. Theresults showed that there was significant positive correlation between cardiac autonomicneuropathy (CAN) and diabetic duration more than 5 years.

Conclusion
Although there were no association between impaired awareness of hypoglycemia and cardiac autonomic neuropathy, it is important to screen for CAN in patients with IAH, especially that CAN isusually asymptomatic among children with type 1 diabetes.