bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Topical Anticholinergic in Control of Symptoms in Patients with Vasomotor Rhinitis and non-Vasomotor Rhinitis Patients and Normal Individuals. A Controlled Comparative Study
Authors: Sabry Sabry Magdy , Fawaz Samia Ahmed , Salman Manal Ibrahim , Askoura Anas Mohamed , Mady Ossama Mustafa , Anter El sordy Moustafa Ahmed Mahmoud 
Published: July 2024

Abstract

Background
The use of a topical anticholinergic medication, ipratropium bromide, and its ability to inhibit methacholine and rhinitis-induced hypersecretion is emphasized. Ipratropium bromide appears to be both safe and effective in reducing this troublesome symptom. This study is designed to show the therapeutic effect of anticholinergic local treatment on nasal mucosa in patients with vasomotor rhinitis.

Objective
To assess the therapeutic effect of local anticholinergic treatment on nasal mucosa in patients with vasomotor rhinitis compared to non-vasomotor (allergic) patients and normal individuals, and if there any down regulation of the muscarinic receptors or not.

Patients and Methods
This prospective interventional study was conducted in Otorhinolaryngology Department, Faculty of Medicine, Ain Shams University. This study was conducted on 60 cases. All patients were divided into 3 groups: Study group (1): includes 20 patients diagnosed clinically non allergic rhinitis suggestive to be vasomotor rhinitis. Study group (2): includes 20 patients diagnosed as allergic rhinitis. Study group (3): includes 20 patients performing surgery for non-vasomotor rhinitis non allergic causes (as septoplasty or rhinoplasty).

Results
Comparison between the pre and post SNOT questionnaire of symptoms among vasomotor group showed that there was a significant difference between the pre and post treatment SNOT questionnaire symptoms; Nasal obstruction, runny nose, post nasal drip, thick nasal discharge and lack of good night sleep. Among allergic cases group, there was a significant difference between the pre and post treatment immunohistochemistry findings considering epithelium, glands, arteries and veins. 20% of cases had grade 3 epithelium before treatment while after treatment, this was dropped to 0%. Comparison between the pre and post SNOT questionnaire of symptoms among allergic group showed that there was a significant difference between the pre and post treatment SNOT questionnaire symptoms; runny nose, post nasal drip, and thick nasal discharge. Among non- vasomotor rhinitis non allergic causes (as septoplasty or rhinoplasty) group, there was a significant difference between the pre and post treatment IHC findings considering epithelium, glands, and arteries, however no significant difference between the pre and post IHC veins grade. Also, there was no significant difference between the pre and post treatment SNOT questionnaire symptoms.

Conclusion
Topical anticholinergic such as ipratropium bromide nasal spray are effective in treating rhinorrhea symptoms in allergic and non-allergic rhinitis. Further controlled studies with larger sample size and longer follow-up are needed to confirm our results and to identify risk factors of adverse events.
Incidence of Pancreatic Leakage in Isolated Biliary Limb Roux-en-Y Reconstruction in Whipple Procedure
Authors: Wagdy Hesham Hasan , Khalil Ahmed Abdelrazik , Saber Hatem Sayed , El Din Rashed Amier Mohamed Ahmed Gamal 
Published: July 2024

Abstract

Background
Whipple is currently the procedure of choice in the treatment of localized pancreatic cancer. Isolated Roux-en-Y loop pancreaticojejunostomy was proposed as a method of reconstruction following pancreaticoduodenectomy. The idea is to isolate the bile from pancreatic secretions to minimize pancreatic enzyme activation and ultimately pancreatic fistula formation. It was also proposed that if a pancreatic fistula develops, it will be a pure fistula and thereby more benign as opposed to a mixed pancreatic fistula containing bile.

Objective
To estimate the incidence of pancreatic fistula in patients undergoing isolated Roux-en- Y hepaticojejunostomy reconstruction following pancreaticoduodenectomy.

Patients and Methods
In this prospective observational study, our aim is to calculate the incidence of post-operative pancreatic fistula in 20 patients that underwent Roux-en-Y isolated biliary limb reconstruction following pancreaticoduodenectomy for the treatment of pancreatic cancer. The study includes patients that underwent this procedure at Ain Shams University Hospitals in the period between January 2021 and July 2022 with a post-operative follow up period of 3 weeks. Patients were diagnosed with pancreatic cancer using MRI or CT scans with some of them also undergoing endoscopic US with biopsy. They were then admitted to one of the two main Ain Shams University Hospitals for pre-operative preparation.

Results
Our study did no estimate post-operative complications such as delayed gastric emptying and wound infection. Pancreaticoduodenectomy is a major surgery that carries a significant burden in terms of morbidity and mortality. Post-operative pancreatic fistula can be fatal as it can lead to vascular pseudoaneurysms that may fatally rupture. The idea behind using isolated biliary limb roux-en-y reconstruction is to alleviate the morbidity caused by post-operative pancreatic fistula.

Conclusion
Further comparative studies with a higher number of patients are recommended to assess and compare the value of isolated biliary limb reconstruction when compared to conventional reconstruction.
Assessment of Progastrin Releasing Peptide in Gastric Cancer Patients
Authors: Mohamed Kamal Maha Mohsen , Saady Khayyal Ahmad El , Anwar Christina Alphonse , Abdel Rady Allam Radwa Adel 
Published: July 2024

Abstract

Background
Gastric cancer is the 3rd cause of cancer related deaths and fifth most common malignant tumor worldwide. It`s prevalence is increasing in conjunction with H.Pylori infection, smoking, alcohol consumption, bad nutritional habits (smoked food, food rich in salt and nitrites, processed meat), obesity, genetic predisposition.

Aim of the Work
To investigate associations among serum ProGRP levels and clinicopathological parameters, and to evaluate the diagnostic value of serum ProGRP for GC.

Patients and Methods
The current study was conducted at Damietta cardiology and gastroenterology center in association with Ain Shams University Hospitals aiming to elucidate the diagnostic value of serum progastrin releasing peptide in patients with gastric cancer. A total of 75 subjects were enrolled in the current study, and they were divided into three equal groups; the first one included 25 healthy controls, the second one included 25 patients with benign gastric lesions, while the third one included 25 patients with malignant gastric lesions.

Results
Our study showed the following findings: CEA had sensitivity and specifity of 64% and 60 % for differentiating between benign and malignant group which means low diagnostic ability of CEA in detecting gastric cancer. Progastrin Releasing peptide (Pro GRP) had 96% sensitivity and 96% specifity in differentiating between benign and malignant groups which means higher diagnostic abilities of Pro GRP in cancer stomach.

Conclusion
Based on thde previous findings we recommend: Use of progastrin Releasing peptide (PRP) as screening marker for patients suspected to have gastric cancer as it has been proved to higher diagnostic abilities than CEA. Evaluate PRP role in monitoring for tumor staging and prognostis.
Measurement of Vitamin D Level among Covid-19 Patients and its Correlation with Severity of the Disease
Authors: Morad Caroline , Habeeb Reem , Yassin Esraa , Khalil Salma 
Published: July 2024

Abstract

Background
Coronavirus disease 2019 (covid-19) is defined as illness caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first identified among an outbreak of respiratory illness cases in Wuhan City, China. Vitamin D is known to play a key role in the maintenance of bone health and calcium–phosphorus metabolism, yet many other functions of this vitamin have been recently postulated, such as modulation of the immune response in both infectious and autoimmune diseases. Different studies showed that severity of covid-19 infection is directly related to vitamin D level.

Methods
This is an observational cross-sectional study, which includes 80 COVID-19 patients, and admitted in the ward and ICU of EL Medany Hospital, EL Demerdash and EL Obour specialized hospital. All patients had positive PCR for COVID-19. Chest CT without contrast was done for all patients and categorized according to CORAD staging. Serum vitamin D level was measured, besides laboratory inflammatory markers (CRP, ferritin, d-dimer), kidney and liver function tests, and complete blood picture.

Results
Our study included 80 patients; 33 males and 47 females with mean age of (51±10.5 years). Measured Vitamin D level range was (10±9 ng/mL). It was found that male patients had higher level of serum vitamin D (12.6±8.6 ng/mL) than female patients (11.5±9.5 ng/mL) but with no statistically significant difference. The commonest presentations were sore throat (97.5%), and fever (93.75%). COVID-19 patients presenting with cough and fever had highly significantly lower levels of vitamin D than patients not presenting by these symptoms (P-value 0.006, 0.032) respectively. In the current study, patients with CORAD 5 in chest CT had the lowest vitamin D level (9.6±7.8 ng/mL), compared to patients with CORAD 3 (13.6±9.7 ng/mL), and CORAD 4 (11.8 ±8.8 ng/mL). According to the correlation analysis, a decrease in vitamin D levels was associated with more severe COVID-19 cases, with significantly higher blood levels of inflammatory markers CRP and ferritin (P-value 0.02, 0.01). No correlation was found between vitamin D levels and hemoglobin level, white cell count, platelet count, or D-Dimer.

Conclusion
Our findings suggest that the COVID-19-positive individuals with lower vitamin D levels, had significantly higher blood levels of inflammatory markers (Ferritin and CRP), and increased frequencies of ground-glass opacity appearance in chest CT scans. Accordingly, vitamin D deficiency may be a marker of poor prognosis in COVID-19 patients.
Study of the Efficacy of Sublingual Route Administration of Levothyroxine Na Tablets vs Oral Route in Cases with Refractory Primary Hypothyroidism
Authors: Muhammed Eid Yara , Abu Shady Manal Mohammed , Eldin Ahmed Nour , El Halawany Salah Hussien , Nesim Mina Mikhael , Muhammed Elshamy Gehad Soliman 
Published: July 2024

Abstract

Background
Hypothyroidism is a common disorder, with a prevalence of approximately 5% and incidence of approximately 250 /100,000 per year in the adult population both prevalence and incidence keep raising. Levothyroxine is the recommended hormone for replacement therapy in both overt and subclinical hypothyroidism.

Aim of the Work
Levothyroxine (L-T4) is the standard therapy of hypothyroidism. Our purpose was to compare the efficacy of the L-T4 sublingual tablet administration to standard oral L-T4 tablet in hypothyroid patients with refractory hypothyroidism.

Subjects and Methods
Our study was conducted on 40 patients who were documented to be refractory to oral thyroxine age range 18- 55, 38 females and 2males. Patients were recruited from Endocrinology and Metabolism clinic at Ain-Shams University and Internal medicine outpatient clinic at 6th of October University during the period from June 2019 to October 2020 Informed consent was obtained from all subjects.

Results
In our study showed a significant decrease in mean TSH (write the figures) on sublingually administrated levothyroxine tablets compared to orally administrated levothyroxine tablets and a significant rise of mean free T4 after 1 week. yet after 6 weeks there was insignificant difference of FT4 compared to oral levothyroxine. Patients who were antiparietal cell antibody positive demonstrated a non significant rise of free T4 level with almost doubling of level compared to oral levothyroxine at 1 week and 6 weeks interval, this was associated with a significant decline of serum TSH at 6 weeks interval. Also This was associated with a significant improvement in hypothyroidism symptoms

Conclusion
In conclusion, our study indicated that sublingual route for LT4 tablet administration was safe and innovative route for LT4 administration,it could improve compliance, overcome many obstacles with oral administration for intake with food,coffee,drug interaction and GI malabsorption.
Surgical Outcome of the Endoscopic Endonasal Approach in Giant Pituitary Adenomas: A Systematic Review
Authors: El-Bahy Khaled M , Kotb Mohamed M , Abdel –Latif Assem M , Ahmed Abd El Rahman E 
Published: July 2024

Abstract

Background
Pituitary adenomas are the third most common intracranial tumors comprising about 10%–15% of all tumors. Giant pituitary adenomas (GPAs) are a subset of pituitary tumors. Most giant adenomas are slowly growing and histologically benign in nature despite the giant in size and difficulties to manage. Diverse surgical techniques including microscopic transsphenoidal, endoscopic transsphenoidal, transcranial transcavernous, and a combination of both suprasellar and infrasellar techniques have been developed to treat giant tumors with extension into surrounding structures. The development of the endonasal endoscopic approach for the resection of pituitary adenomas has been one of the most important advances for the treatment of pituitary tumors in the last decades since 1997.

Aim of the Work
analyze the collective outcomes from studies discussing endoscopic endonasal transsphenoidal approach in managing giant pituitary adenomas regarding extent of tumor resection, visual improvement and hormonal control.

Methodology
This systematic review included a discussion of all available studies meeting the eligible criteriaincluding: well conducted descriptive studies, cohort, articles, analytic studies and the literature of reviews.

Results
Surgical intent of gross or near total resection, primarily for the purpose of improving outcome, can be complicated by injuries that lead to a worse outcome and protracted clinical course. In this respect, patient-oriented outcomes (POEMs) are a point of emphasis in this review.

Conclusion
The endoscopic endonasal approach is an effective approach for giant pituitary adenomas with high rates of near or complete resection, visual improvement, and low rate of complications.
The Role of Corticosteroids in Prevention of Neonatal Respiratory Morbidity in Term Elective Cesarean Section A Prospective Observation Study
Authors: Salama Mohamed Hamed , Nabhan Ashraf Fawzy , El-Posty Faten El-Sayed , Zeinhom Ahmed Mohamed 
Published: July 2024

Abstract

Background
Caesarean sections continue to increase day by day in both developed and developing countries, which is associated with increased respiratory distress syndrome (RDS), the key reason for early neonatal morbidity and mortality.

Objective
To assess the effect of routine prophylactic corticosteroids before elective caesarean section after 37 weeks of gestational age, on neonatal respiratory morbidity.

Methods
A prospective observational study was conducted on all pregnant women undergoing elective caesarean sections between 37-42 weeks at Ain Shams University Maternity Hospital. Over an 8- month period (from November 2020 to June 2021), 1105 cases were divided into the exposed group (A), (N = 877) who received prophylactic dexamethasone, and 228 cases in the non-exposed group (B) who did not receive dexamethasone. Outcome measures were the incidence of transient tachypnea of the newborn, and NICU admissions due to respiratory morbidity. Data were analyzed using SPSS 22.

Results
Overall, there was no statistically significant difference in the incidence of TTN or RDS. No cases of TTN were found in exposed subgroup, versus 1 (0.4%) in non-exposed group (p = 0.745). The respiratory distress (RDS) in the exposed subgroup was 4 cases (16.7%) versus 18 (7.9%) in non- exposed group (p = 0.148). While the admission to the neonatal intensive care unit (NICU) due to respiratory morbidity after an elective caesarean section was 4 cases (16.7%) in the exposed subgroup versus 19 cases (8.3%) in the non-exposed group (p = 0.178).

Conclusion
Routine administration of prophylactic antenatal corticosteroids before elective caesarean sections at term does not reduce the risk of admission to the NICU compared to non- administration.
Open Reduction and Internal Fixation versus Minimally Invasive Plate Osteosynthesis in Management of Distal Tibia Extra-Articular Fracture (Mini Thesis)
Authors: Abdelmalek Hesham Abdelhameed , Nassar Wael Ahmed , El-Sayed Awad Mohammed 
Published: July 2024

Abstract

Background
Extra-articular distal tibia fracture is one of the difficult fractures to treat and the optimal treatment remains controversial, however plates seem to be the obvious choice for treating this type of fractures. The mechanism on how to achieve the balance between anatomic reduction and indirect reduction as well as direct and indirect healing remains unclear. Thus, the key point is whether to use ORIF or MIPO in treating fractures.

Aim of the Work
to provide a complete overview of the optimal plating technique for distal tibia fractures by evaluating and comparing the clinical and functional outcomes of minimally invasive plate osteosynthesis (MIPO) vs Open reduction and internal fixation (ORIF) for treating extra- articular distal tibial fractures. Outcomes of interest include operation time, time to union, non-union, mal-union, infection, secondary operations, and functional outcomes (AOFAS score).

Patients and Methods
From August 2020 to August 2021, a prospective randomized study was conducted at the department of orthopedic surgery of Ain-shams University Hospital including 36 patients to compare MIPO vs. ORIF in fixation of extra-articular distal tibial fractures. The patients were allotted to the MIPO or ORIF group with the flip of a coin.

Results
Regarding complications rate, no cases developed infection in MIPO technique. On the other hand, the ORIF technique had an infection incidence of 16.6% overall, with two cases (11.11 %) developing superficial infection and one case (5.56 %) developing deep infection. There was no significant difference in the incidence of mal-union between both techniques with no cases of non-union in both groups. The MIPO group had only one case of sagittal plane malunion (5.56%), compared with no cases in the ORIF group. There was no significant difference between both groups in secondary operations rate, with one case in each group.

Conclusion
Both MIPO and ORIF have similar therapeutic efficacy regarding the functional outcome and can be used safely in distal tibial extra-articular fractures. Although MIPO is advantageous over ORIF with earlier weight-bearing, earlier union, and clinical lower incidence of infection, it has delayed operation time.
Management of Massive Irreparable Posterosuperior Cuff Tears: A Systematic Review for Clinical & Functional & Radiological Outcomes
Authors: Saed Ahmed E L , Haroun Haitham , Mohamed Abdelghany Badr Ahmed Mohamed 
Published: July 2024

Abstract

Background
The management of massive irreparable cuff tears (MIRCT) remains a highly controversial subject with many possible surgical and non-surgical interventions and no clear evidence regarding the most effective and beneficial intervention. Different management options include: conservative management, partial repair, tendon transfer, superior capsular reconstruction, subacromial spacer insertion, reverse total shoulder arthroplasty (RTSA).

Aim of the Work
The aim of this systematic review is to compare the various methods of management of posterosuperior cuff tears without arthropathy to reach the most effective and sustainable mode of management.

Patients and Methods
A randomized controlled trial, non-randomized clinical trials, prospective and retrospective comparative cohort studies and case series. We will exclude cross-sectional studies, case reports and literature not in English.

Results
There is no high quality evidence on management of MIRCT. There was no Level I or II evidence. We included 69 papers that studied different modalities of management of MIRCT, 31 of level III and the remaining were of level IV evidence. Consequently, it’s still difficult to recommend one method of management over the other regarding the management of irreparable cuff tears. Patient age, demands, expectations, thorough clinical examination, surgeon experience and preference are still a major deciding factor when choosing and appropriate method.

Conclusion
Due to the unavailability of high-quality clinical studies available for guiding management of irreparable MRCT, it is consequently not possible to recommend for or against any specific treatment strategy. Rather, clinical experience, patient factors, patient expectations, and rotator cuff tear characteristics should guide clinical decision-making. Physical therapy compared to surgical treatments may have inferior outcomes. Standardized data collection, reporting and terminology are key to enhancing the quality of evidence-based medicine.
Prevalence of Intestinal Parasitic Infections among Food Handlers from Greater Cairo, Egypt
Authors: El Araby A , Shihata M A , Aminu H A , Khalifa K E 
Published: July 2024

Abstract

Background
Foodborne illnesses caused by intestinal parasitic infections (IPIs) are among the major health problems especially in developing countries. Food handlers play an important role in transmission of IPI during manufacturing, processing, handling, and serving of foodstuff.

Objectives
The aim of the present study was to determine the prevalence of IPIs among food handlers in Greater Cairo, Egypt and their associated risk factors.

Methodology
A cross sectional study was designed whereby 250 food handlers attending four provision health offices from different governorates of Greater Cairo were examined. The demographic data, job title and position, health certification as well as risk factors that might increase the transmission of IPIs were collected in a pre-designed questionnaire. Stool samples were collected from all participants and examined by direct wet/iodine mounts, formol diethyl acetate and modified Ziehl_Neelsen staining techniques.

Results
65 food handlers (26%) were found to have IPIs. The commonest parasites detected were Entamoeba histolytica (24.6%), Entamoeba coli (20%), Blastocystis hominis (16.9%), Giardia intestinalis (12.3%), followed by Enterobius vermicularis (10.8 %), Ascaris lumbricoides (7.7 %) and Schistosoma mansoni (3.1%). Higher, statistically significant (P &lt; 0.001), prevalence of IPIs was found among food handlers from rural areas, having low educational levels, not having previous health certificates and among those working in popular restaurants and those having poor personal hand hygienic measures. While no differences in prevalence of IPIs was found regarding age, sex, and work experience duration.

Conclusion
It was concluded that implementation of governmental policies ensuring routine medical checkup and continuous professional training and education of food handlers are essential for prevention of IPIs among food handlers.