bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-Term Results after Reversed Total Shoulder Arthroplasty
Authors: Mahmoud Mohamed Mahmoud Shoukry , Samy Abou Elsoud Maged Mohamed , El-Rhaman Amr Ahmed Abd , Mohamed Haytham Abdelazim , Khater Ahmed Hany , Abd El-Wahab Mahmoud Mohamed 
Published: July 2024

Abstract

Purpose
Massive rotator cuff tear, with or without arthritis and proximal humerus fracture non-union or malunion, lead to the loss of center of rotation of shoulder, while anatomical total shoulder arthroplasty does not provide a stable center of rotation, Therefor reversed total shoulder arthroplasty (RTSA) is the suitable method for these indications, as well as in elderly patients with primary glenohumeralosteoarthritis because anatomical total shoulder arthroplasty has the risk of failure either due to loosening of glenoid component or cuff tear. This study aimed to determine the short-term results after RTSA in patients a with massive cuff tear, acute proximal humerus fracture, proximal humerus fracture malunion or non- union, and primary glenohumeralosteoarthritis.

Methods
This one arm clinical trial (interventional study) conducted in Ain Shams University Hospitals included 16 patients who underwent RTSA. Short-term outcomes included constant score, American Shoulder and Elbow Surgeon (ASES) score, and range of motion (ROM). Patients with rotator cuff arthropathy, massive irreparable cuff tear with or without glenohumeralarthritis, elderly patients with acute complex proximal humerus fracture, malunited or nonunited proximal humerus fracture, and patients with glenohumeralosteoarthritis were included. Patients who were aged &lt;50 years were excluded, as well as patients with axillary nerve injury or deltoid muscle dysfunction.

Results
This study included 16 patients, including 8 males and 8 females. The mean age was 64.19 years and the duration of follow up-was 1 year postoperatively. Seven Patients with massive irreparable cuff tear were included, of them, 1 had associated anterior shoulder instability and recurrent anterior dislocation, 3 had a four-part proximal humerus fracture, 2 had fracture dislocation, 2 had proximal humerus fracture non –union, 1had neglected dislocation, and 2 had glenohumeralosteoarthritis. Outcomes were followed using constant and ASES scoring systems, and ROM. The global postoperative gain was statistically significant (p &lt; 0.001). Complication in the form of dislocation occurred in one case that had RTSA after fracture non-union.

Conclusion
Good clinical and functional outcomes were achieved after RTSA, not only for classic massive cuff tear indication, but for other disorders, such as acute proximal humerus fracture, fracture non-union, and primary glenohumeralosteoarthritis. However, the outcomes after irreparable cuff tear were the best among all indications, while fracture non-union had the least improvement in clinical outcomes. Improvements in prosthesis design, surgeon’s experience, and clinical results are necessary to optimize this treatment for many shoulder conditions.
Outcome of Internal Fixation by Cephalomedullary Nail versus Outcome of Bipolar Hemiarthroplasty in the Treatment of Unstable Pertrochanteric Femoral Fractures in Elderly: Systematic Review and Meta-analysis
Authors: Elgebeily Mohamed Abdelmoniem , Ibrahim Mohammed Ali , Abdelwahab Ibrahim Ibrahim 
Published: July 2024

Abstract

Background
Pertrochanteric femoral fractures are extracapsular metaphyseal fractures of proximal femur that involve the region between the femoral neck and shaft. Intertrochanteric femur fractures, the most common type of fragility fractures in the elderly, account for 55% of proximal femoral fractures. Intertrochanteric femur fractures have high fatality and disability rates, resulting in a huge burden on the economy and on society.

Objective
To compare the advantages and disadvantages of the PFN and BHA to provide reliable evidence for clinicians in selecting the optimal treatment for unstable pertrochanteric fractures.

Patients and Methods
This systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines.

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

Data Extraction
Data were independently extracted by two reviewers and cross-checked.

Results
This study included 12 samples which recruited 1019 patients with unstable intertrochanteric fractures, form which 515 patients underwent bipolar hemiarthroplasty (BHA) and 504 patients underwent proximal femoral nail (PFN). No significant difference between BHA and PFN in operative time and post-operative hospital stay was found. Intra-operative blood loss and incidence of blood transfusion was higher in BHA compared with PFN. HHS was higher after PFN than after BHA. Patients underwent PFN required larger period for partial weight bearing compared with who underwent BHA. There were no statistically significant difference between both groups regarding postoperative mobility scores, reoperation rate, incidence of infection and limb length alteration. The overall mortality rate risk ratio revealed that the incidence of mortality was higher after BHA than PFN.

Conclusion
Both PFN and BHA can be used in managing fractures of the Intertrochanteric in elderly patients. PFN establishes itself as a better modality than BHA due to lower postoperative mortality and better functional outcomes. BHA should ideally be reserved for lower life expectancies and those requiring immediate weight bearing patients.
Bone Transport through Induced Membrane Technique versus Conventional Bone Transport Technique in Management of Bone Defects of Lower Limbs
Authors: Thakeb Mootaz Fouad , El Gebeily Mohamed Abdel Monaem , El Kersh Mohamed Ahmed , Baraka Mostafa Mohamed , Khairy Kozman Michael Amir 
Published: July 2024

Abstract

Objectives
To assess whether Bone transport through induced membrane (BTM) has better outcomes regarding docking site union and infection recurrence than conventional bone transport (BT) or not in the treatment of infected lower limb long bones defects.

Methods
A prospective randomized controlled study in a single institution was conducted. A total of 30 patients with infected non united fractures of long bones of lower limbs were divided into 15 patients (10 femurs, 5 tibias) treated by BTM and 15 patients (3 femurs,12 tibias) treated by BT. The outcome measures includes external fixation time (EFT), external fixation index (EFI), docking time (DT), bone and functional outcomes evaluated by the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system, postoperative complications evaluated by Paley classification and number of additional operations.

Results
The mean docking time (DT) was significantly lower in BTM group in comparison to BT group (3.67 ± 0.82 months vs 4.80 ± 0.86 months respectively) (p value 0.001). Docking site nonunion and infection recurrence were significantly lower in BTM group in comparison to BT group (0% vs 40% respectively) (p value 0.02) and (0% vs 33.3% respectively) (p value 0.04). Mean number of additional operations per patient was significantly lower in BTM group in comparison to BT group (0 vs 0.80 ± 1.08 operations respectively) (p value 0.01)

Conclusion
Both BTM and BT achieved satisfactory postoperative bone and functional outcomes in patients with infected long bones defects of lower limbs, while BTM had significantly faster docking site union, lower incidence of postoperative complications including docking site nonunion and infection recurrence rates and lower number of additional operations needed at the expense of 2 staged procedure in comparison to BT.
Minimally Invasive Sacroiliac Joint Fusion: A Systematic Review and a Meta-Analysis
Authors: Abouelela Amr A K H , Sallam Ahmed Mohammed , Mohamed Abdelkader Amr Salah 
Published: July 2024

Abstract

Background
Low back pain (LBP) is a worldwide health problem and one of the top three causes of health deterioration in affluent countries. After the common cold, LBP is the second most prevalent reason for visits to primary care providers. Aside from high levels of disability and lost income, LBP increases the risk of falls in the elderly, which can result in hip and/or spinal fractures, increasing morbidity and mortality in this vulnerable group.

Materials and Methods
Application of inclusion and exclusion criteria to study Abstracts yielded 9 articles. A total of 390 studies were identified from the database search. After review, a total of 9 studies consisting of 1224 patients with SIJF were selected.

Results
A total number of 1224 patients with SIJF were selected. The 9 studies ranging from 2012 to 2019. Among the 9 studies were 4 randomized control trials and 2 studies were retrospective studies. Among the patients, 407 males and 817 females. The age ranged from 24 years to 81 years among the 9 studies. The follow-up duration ranged from 6 months to 2 years among our studies.

Conclusion
The meta-analysis performed in this systematic review demonstrated that patients who fail conservative therapy and have a positive diagnostic SI joint block may clinically benefit from minimally invasive sacroiliac joint fusion using a lateral trans-articular approach. Sacroiliac joint fusion appears to be a satisfactory procedure for alleviating low back pain.
Outcome of Flexible Intramedullary Nailing versus Plating in Treatment of Diaphyseal Femur Fractures in Paediatrics: Systematic Review and Meta-analysis
Authors: Saad Torkey Mohamed Eid , Goda Ayman Hussein , Elhusseiny Karim Tarek 
Published: July 2024

Abstract

Background
Pediatric femoral fractures are the most the common long bone fracture in children, with one third of these occurring between ages 5 to 12. These injuries are usually the result of road traffic accidents, sports and non-accidental injury. Different modalities exist for managing these fractures, often stratified according to the age of the patient.

Aim of the Work
The aim of this work is to provide a complete overview of the optimal surgical treatment of diaphyseal femur fractures in children by evaluating and comparing the clinical and functional outcomes of flexible intramedullary nailing versus plating for such fractures.

Patients and Methods
This review followed the Cochrane Handbook's standard methodology and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- analyses (PRISMA) statement guidelines.

Result
In patients undergoing flexible nailing, the surgical variable data found this treatment modality to be superior in terms of certain operative features: shorter operative duration times (p = 0.00001), smaller volumes of estimated blood loss (p = 0.00001). There was no difference regarding length of hostital stay (p = 0.59). This suggests that flexible nailing may offer increased safety to patients in terms of duration of anesthesia, volume of blood loss, and cost of surgery when compared to plating. However, Secondary outcome analysis also found a statistically significant increased risk of malunion (p = 0.002) and metalwork irritation (p = 0.00001) when using FIN compared to plating techniques. There was no difference regarding risk of infection (p = 0.53) and developing leg length discrepancy (p = 0.44).

Conclusion
Options for stabilization and fixation in this age group include flexible nailing, plating (open or sub-muscular), external fixation, or hybrid techniques.
Valgus Osteotomy versus Arthroplasty for Ununited Femoral Neck Fractures: A Systematic Review
Authors: El Dayem Sherif Mostafa Abd , Mohsab Ahmed Mohamed , Mohaseb Ahmad Mohamed 
Published: July 2024

Abstract

Background
Fractures of the neck of femur in young adults tend, unlike their counterparts in older people, to be a relatively higher energy injury and require timely and meticulous diagnosis and management. Anatomical reduction and stable internal fixation are essentials for achieving the goals of treatment in this young population allowing preservation of the femoral head while minimizing rates of non-union and osteonecrosis.

Aim of the Work
The aim of this systematic review is to collate evidence from comparative studies to look for significant differences between valgas osteotomy &arthroplasty in non united femoral neck fractures in &lt; 50yr old patients.

Patients and Methods
Only studies with Randomized controlled trials and comparative non controlled trials had been included. The study included Valgas osteotomy & arthroplasty for ununited femoral neck fractures. Application of inclusion and exclusion criteria to study Abstracts yielded 11articles. The full-text articles for these 40 studies were then reviewed and subjected to our inclusion criteria. A total of 11 articles were eligible for final systematic review.

Results
There was improvement in Harris hip score in all included studies ranged from 79.8 to 95. In comparison between two groups, groups with THA had significantly higher Harris hip score than osteotomy score. In this review reoperation and infection were common among osteotomy group than total hip arthroplasty group.

Conclusion
Although non-union problems following femoral neck fractures are common, the primary objective is to preserve the hip, by seeking alternative methods, specifically in young patients, and considering that the femoral neck can usually remain viable. Therefore, alternatives such as valgus osteotomy, which enables union by solving mechanical issues and allows patients to live with their own bones, have long been in use and successful Valgus intertrochanteric osteotomy is the treatment of choice for active patients aged less than 50 years with a nonunion of a femoral neck fracture. This technique requires precise preoperative planning and intraoperative skill. Patients should be warned of the risk of avascular necrosis, as well as the difficulty in performing revision arthroplasty in this setting.
Internal and External Rotators Muscle Strength Ratio and Acromio-Humeral Distance as Predictors of Shoulder Injuries in Volleyball Players
Authors: El Sebaie Mona Abdullah , Elsaid Ahmed Mohamed , Kotb Ahmed Mostafa , El- Mallah Reem , Mohamed Hassan Amr Mohamed Taha 
Published: July 2024

Abstract

Purpose
We aimed to investigate the ratio between strength of internal and external rotators of shoulder using handheld dynamometer and acromio-humeral distance actively and passively using musculoskeletal ultrasound to identify a relation between strength imbalance and shoulder joint injuries in Egyptian volleyball players.

Methods
A case control study, carried out on 60 volleyball players, subdivided into 2 subgroups, 30 with shoulder pain (injured group) and 30 apparently healthy players as a control group. The internal and external rotator muscles were measured with and held dynamometer, and acromio- humeral distance was measured using musculoskeletal ultrasound.

Results
injured group included 10 female players (33.3%) and 20 male players (66.7%), age ranged between 16-30 years old, while control group included 4 females (13.3%) and 26 males (86.7%). Internal and external rotation strength ratio was less than 0.9 in injured group in the dominant arm, in favor of the normal group with statistical difference between them (p &lt; 0.004). Acromio-humeral distance actively in injured group ranged from 0.45 to 0.87cm with mean ±SD of (0.64±0.07), less than normal group which ranged from 0.7 to 1cm with a mean ±SD of (0.79±0.08) (p &lt; 0.000)

Conclusion
Weakness of external rotators muscles strength will decrease ratio between external rotator/internal rotator muscles, reducing the acromio-humeral distance especially during abduction, leading to shoulder injuries among volleyball players.
Study of the Effect of Tumor Necrosis Factor Alpha (TNF-α) Antagonist (Adalimumab) on Giardiasis in Mice
Authors: Habib Faiza S M , Badawy Abeer F , Abd Elhafiz Hala E , Thabet Engy E 
Published: July 2024

Abstract
Giardia lamblia (G. lamblia) is the most common worldwide intestinal protozoal. Serum TNF-α contributes to the recovery from Giardia lamblia infection especially in the first and second week of infection. TNF-α antagonists are biologics used to treat many inflammatory diseases as rheumatoid arthritis. The present study aimed to study the effect of TNF-α antagonist (Adalimumab) on experimental giardiasis in mice by parasitological and histopathological examination. A total of 45 parasite-free laboratory-bred Swiss albino mice included into 2 main groups: test group and control group were used. Test group included mice infected with G. lamblia and receiving three intraperitoneal Adalimumab injections from days 9 till 15 post infection (pi). This group was further subdivided into 3 subgroups (Ia, Ib, Ic) according to Adalimumab doses which were 1.5, 3 and 6 mg/kg BW, received, respectively. Control group (non-Adalimumab-treated group) included a non-infected healthy group and Giardia -infected group. Monitoring the serum TNF-α level in all mice was done on two occasions (day 16 and 28 pi) by ELISA to follow variation in its level with and without administration of the drug. Infection outcome was assessed by following cyst shedding in stools of infected mice on intermittent days, counting trophozoites in intestinal wash, registering weight of animals, and recording pathological changes occurring in histopathological sections from small intestine. Highly significant increase in serum TNF-α was recorded in infected control mice on day 16 post-infection than in normal control group. Similarly, a significant increase in TNF-α level in the 3 test subgroups but attaining significant lower levels. On day 28 post infection, serum TNF- α level decreased in all infected mice with no significant differences being higher in infected control group than in non-infected control group. On assessing the effect of decreased serum TNF-α by the drug on infection outcome, highly significant increases in cyst shedding were recorded in the test group specifically group receiving 3 mg/kg BW than in control infected group on day 16 pi, and in trophozoite counts on day 28 pi. Mice weight gain was highly significant being more in control non-infected group than in control infected group. It was significantly lower in test group than normal infection control. The intestinal sections of test subgroups showed moderate to severe inflammatory reaction with more inflammatory cellular infiltration in the lamina propria causing villous shortening and blunting more than that observed in infection control group. Furthermore, lymphoid follicles and sloughing of the epithelium were only observed in test subgroups on day 16 p.i. It was concluded that TNF-α antagonist (Adalimumab) led to increased parasitic load as evidenced by cyst shedding, trophozoite count, less weight gains with moderate to severe histopathological damage in test subgroups.
Serum Angiotensin II Level in Pediatric Patients with COVID-19 and its Correlation with the Disease Severity
Authors: Fouda Eman Mahmoud , Wahba Nancy Samir , Abdel Fattah Samah Ibrahim , Hamza Heba Moustafa 
Published: July 2024

Abstract

Background
Coronavirus disease 2019 (COVID-19) is a newly discovered RNA betacoronavirus infection. It has been caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Angiotensin II (Ang-II) is a mitochondrial toxin that under normal circumstances is rapidly removed by angiotensin converting enzyme 2 (ACE-2). SARS-CoV-2 uses the receptor ACE-2 for host cell entry and viral replication. ACE-2 proteins are occupied and downregulated by SARS-CoV-2. ACE-2 downregulation has been directly linked to toxic over accumulation of Ang-II. Accumulating Ang-II triggers many severe and fatal conditions such as acute respiratory distress syndrome (ARDS).

Aim of the Work
To assess the serum level of Ang-II and correlate it with the severity of COVID-19 infection in pediatric patients.

Patients and Methods
This case control study was conducted on 45 positive COVID-19 RT-PCR children who were compared to age and sex matched 45 healthy controls. Clinical examination, laboratory assays and imaging studies were done for the patients group to assess the severity of COVID–19 infection. Serum Ang-II was measured by ELISA for both groups and correlated with clinical (heart rate, blood pressure, respiratory rate and oxygen saturation), laboratory (total leucocytic count, lymphocytes, neutrophils, serum ferritin, ESR and CRP) and radiological (chest x-ray and CORAD score of CT chest ) parameters of the patients.

Results
The median “IQR” of serum Ang-II was significantly higher in the COVID-19 patients than in the controls (100 (88-137) ng/L) versus 20 (15-25) ng/L) (p-value= 0.001). There were statistically significant positive correlations between serum Ang-II levels and different grades of clinical severity classification (rs = 0.92, p-value=0.001) and CORAD score of CT chest. On the other hand, no statistically significant correlations were found between serum levels of Ang-II and total leucocytic count, lymphocytes, neutrophils, ESR and CRP.

Conclusion
Serum Ang-II could be used as a biomarker in predicting the severity of COVID-19 infection in pediatrics.
Clinical and Biochemical Profile of Patients with 46, XY Disorders of Sex Development
Authors: Hassan Ali Nagwa Mosaed , Elsedfy Heba Hassan , Mohamed Ebrahim Salah Mahmoud , Ahmed Mahmoud Rana Abdelhakim 
Published: July 2024

Abstract

Background
Disorders of sex development (DSD) comprise a wide range of conditions with varying features and pathophysiology that most often present in the newborn or the adolescent. Affected newborns are born with ambiguous genitalia, whereas adolescents present with atypical sexual development during the pubertal years.

Aim of the Work
To study the clinical and biochemical profile of patients with 46, XY disorders of sex development.

Patients and Methods
This was a descriptive study, conducted on 50 patients with 46, XY DSD attending the Pediatric Endocrinology clinic, Children's Hospital, Ain Shams University were recruited from April 2019 till April 2020.

Results
In our study 88% of cases were reared as males, while 12% were reared as females. The mean age at diagnosis was 2.48 ± 1.33 years with a range of 1-7 years. Parental consanguinity was present in 28 (56.0%) patients and a positive family history in 10 (20.0%). Mean external masculinization score (EMS) in our study was 3.30 ± 1.81 and ranged from 0 to 9 with a median of 3. The mean of stimulated Testosterone / Dihydrotestosterone (T/DHT) ratio was 17.5 (7.8-26) and ranged between 1.5 and 66.6. The median of Anti Mullerian Hormone (AMH) was 56 ng/ml and ranged between 19.08 and 105 ng/ml. There was correlation between EMS final score and stimulated DHT (r = 0.54, P = 0.000). Of note 6 (12.0%) patients had reconstruction of scrotum, 7 (14%) had undergone inguinal hernia repair, 12 (24%) had undergone correction of hypospadias, 6 (12.0%) bilateral gonadectomy,6 (12.0%) left orchiopexy, 3 (6.0%) right orchiopexy and 10 (20%) bilateral orchiopexy.

Conclusion
Due to the overlapping clinical and biochemical parameters in various subsets of DSD, only a preliminary etiological diagnosis can be made in some cases. Genetic examination with long-term follow-up are needed for a precise diagnosis. Management of these patients is multidisciplinary which needs an endocrinologist, gynecologist, psychologist, pediatrician, and clinical geneticist.