bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iron Metabolism in Pediatric Living related Liver Transplantation
Authors: Abdel Ghaffar Tawhida Yassin , Gawad Tantawy Azza Abdel , El Din El Shazly Lerine Bahy , Rahim El Naghi Suzan Abdel , Safwat Nesma Ahmed , Nasef Amani Abdo 
Published: July 2024

Abstract

Introduction
Iron deficiency is a frequent cause of anemia in liver transplant recipients, especially children. Rejection and infection are incriminated causes for occurrence of anemia after liver transplantation (LR).

Aim of the Work
We aimed to assess iron homeostasis in children who have undergone living related LT (LRLT) and its correlation with occurrence of rejection and infection.

Patients and Methods
The study was conducted on 35 children who have undergone LRLT. The patient characteristics, frequency of infection and rejection episodes, laboratory investigations including complete blood picture (CBC) and Iron profile (total iron binding capacity (TIBC),serum iron and ferritin) during the patient follow up visits were reported.

Results
Males were 68.58% of the studied patients and females were 31.42%. Their ages ranged from 1.3-15 years at time of LT with mean (SD) of 7.18 (3.8)years. The mean (SD) duration since LT was 4.83 (4.2) years. The commonest indication to LT was highgamma-glutamyl transferase (GGT) cholestasis (34.7%) followed by biliary atresia (21.7 %). Thirteen percent of patients had low hemoglobin (Hb) of whom 4.3% had normocytic normochromic anemia and 8.7% had microcytic hypochromic anemia. Serum iron was normal in 79.6% of patients and low in 20.4%, and ferritin was normal in 58.7% of patients and low in 41.3% while TIBC was normal in 82.6% of patients and low in 17.4%. Only serum iron showed significant negative correlation with white blood cells (WBCs) (P &lt; 0.05). The iron parameters levels were not different in patients with no rejection or only one attack of rejection and the patients with multiple rejection episodes (P &gt; 0.05).

Conclusion
Anemia is a reported complication after pediatric LT. Further studies are needed to assess the long term effect of post-LT anemia on patient outcome after LT.
Role of CXCL-10 as a Biomarker for Rheumatoid Arthritis
Authors: Abdulhakim Mervat Mohamed , Ibrahim Soha El-Dessouki , Salama Sherihan Mahdy , Saad Zaghloul Ahmed Saeed 
Published: July 2024

Abstract

Background
CXCL-10 has been detected within sera, synovial fluid, and synovial tissue in patients with RA and identified as a pro-inflammatory chemokine that mediate leukocyte trafficking and modulate innate and adaptive immune responses. It plays a critical role in the inflammatory response and is involved in several biological processes.

Objective
To evaluate the predicative significance of chemokine CXCL10 in rheumatoid arthritis (RA) and to focus on its relation to disease activity.

Patients and Methods
A case control study included 30 patients; were diagnosed with RA, and 30 healthy controls. Clinical examination was done for all patients. Measurement of serum CXCL10 level was done by ELISA, while assessment of disease activity in patients was done using disease activity score (DAS-28). Serum levels of CXCL10 were significantly higher in RA patients than controls.

Results
Serum level of CXCL-10 was ranging from 349–1380 pg/ml with a mean of 784.6 ± 152.2 in RA patients, which was very high level compared to control group the serum level was ranging from 137 – 476.8 pg/ml with a mean of 338.1 ± 125.5. The difference was statistically highly significant (p &lt; 0.001). AUC for CXCL-10 was 0.951 and the 95% CI was ≤ 1. The cutoff point of CXCL-10 was 450 pg/mL were able to differentiate between RA patients and control group. Most of RA patients (70%) were on methotrexate with dose ranged from 12.5–25 mg per week. Thirty-five (58.3%) patients were on steroids with dose 5-20 mg per day. Comparison of CXCL-10 levels in patients with different grades of disease activity had a statistically significant difference between different grades.

Conclusion
Our study supports the critical role of CXCL10 in the RA inflammatory cascade. The correlation of CXCL10 with clinical disease activity suggests that CXCL10 plays a central role in RA inflammation and may serve as a disease activity marker in RA. CXCL10 has a significant role as a biomarker for prediction of RA.
Surgical Management of Painful Digital Neuroma: A Systematic Review
Authors: Zaki Abdelsamie Amany Elsayed , El Barbary Amir Samir , Gad Ahmed Mohamed , Abdelhalim Mohamed Mamdouh 
Published: July 2024

Abstract

Background
Neuromas of the digits can be a mentally and physically disabling condition for patients in this systematic review, the authors discuss a variety of surgical techniques for digital neuroma management.

Aim of the Work
This systematic review aims to analyze and combine the results of relevant studies on surgical treatment for digital neuroma. It aims to determine the overall success of the surgical procedure and identify which techniques are more effective.

Patients and Methods
Four databases, including Embase, Scopus, PubMed, and Google Scholar, were searched for relevant studies. The search spans the years 1990 to 2022. Out of 1490 initial studies, 672 remained after removing duplicates. After screening the Abstracts, 647 were excluded for various reasons, leaving 12 eligible studies for inclusion in the systematic review, which included a total of 309 patients. Outcomes reporting included the visual analogue scale (VAS) to report pain, patient satisfaction, the Semmes-Weinstein Monofilament Test, The two-point discrimination test, a non-standard ordinal scale and the mean follow-up duration.

Results
The studies included neuroma excision, neuroma excision (and implantation into adjacent tissues), centro-central union, proximal relocation, interdigital direct neurorrhaphy, nerve allograft reconstruction, regenerative peripheral interface, dorsal transposition and epineural coaptation, collagen conduits, and muscle-in-vein conduits (MVCs).The results show that a majority of patients achieved pain relief after surgery, with high levels of satisfaction reported in some studies. The most successful surgical approach was not determined since there were no statistically significant differences between the various surgical techniques. However, neuroma excision followed by nerve repair/reconstruction (centro-central union, proximal relocation, direct neurorrhaphy, nerve allograft, regenerative peripheral interface, dorsal transposition and nerve conduit )show magnificent results compared to neuroma excision alone with or without implantation. Factors such as old age, smoking, and high PROMIS Depression scores were found to be independently associated with higher levels of pain interference.

Conclusion
The results suggest that surgical treatment is effective in reducing pain levels, with most patients reporting complete pain relief or improvement. Neuroma excision followed by nerve repair/reconstruction was found to result in better outcomes compared to neuroma excision alone with or without implantation.
Characteristics of Rapid Response Team Calls in a Tertiary Hospital in Egypt
Authors: Hosny Rania , Hussein Rasha Saad , Hakim Sally Adel , Shehad Ihab 
Published: July 2024

Abstract

Background
Rapid Response Teams (RRTs) help in the early recognition of deteriorating patients in hospital wards, and provide the needed management at the bedside by a qualified team.

Aim of the Work
To describe the characteristics of the RRT calls in a tertiary hospital in Egypt.

Patients and Methods
A prospective cohort study for a one-year duration from January 2021 till December, 2021was conducted, during this period a total of 2338 patients were reviewed, and 34 RRT calls were recorded.

Results
Our results showed that 10 calls (63%) of Rapid Response Team calls were in the daytime, and Nurses were the main activators with 27 activations (90%). Modified Early Warning scoring system (MEWS) and Pediatric Early Warning Score (PEWS) used were the main cause of RRT activation with a total of (66.7%), the majority of cases didn’t refer to the Intensive Care Unit (ICU), 19 patients stay in the ward (76%) and 22 cases (100%) were recovered.

Conclusion
More than half of RRT calls were in the daytime, and nurses were the main activators. Most rapid response team activations involve relatively few interventions, patient-activated RRT should consider as a patient right in the future, and further studies showed be conducted to evaluate the best effective methods for applying RRT among different health care facilities.
Comparing the Efficacy of US Guided Pudendal Nerve Block plus Periprostatic Nerve Block versus Periprostatic Nerve Block Alone for Pain Control of Patients During and After Transrectal Biopsy of the Prostate Gland
Authors: Mohamed Eid Mohamed Wael , Abdelwahab Sameh Mohamed , Ibrahim Mohamed Adel 
Published: July 2024

Abstract

Background
Cancer prostate is considered one of the most common cancers among male population. Trans rectal ultrasound (TRUS) guided biopsy has become the main procedure for diagnosing prostate carcinoma, In order to definitively diagnose prostate carcinoma, (TRUS)-guided prostate biopsy is needed.

Aim of the Work
To compare the efficacy, safety of Pudendal nerve block plus periprostatic nerve block with the standard technique (periprostatic nerve block).

Patients and Methods
during a period of 6 months duration A total of 30 patients (group 1 [Pedundal nerve block plus periprostatic nerve block], n = 15; group 2 [periprostatic nerve block], n = 15) were included in the study. all patients were instructed about how to assess pain and discomfort level using a visual analog scale (VAS) from 0 to 10, with an 11-point score (0 = no pain, 10 = intolerable pain).

Results
in our study 30 male patients were divided into 2 groups, group 1 underwent to (PPNB) and group 2 (PPNB + pudendal block). The mean age of the studied group was 58.8 ± 10 years old. All patients hadn’t previous history for prostate surgery nor for rectoanal disease. In our study we evaluated pain scores immediately after the procedure. Regarding the relation between VAS and two studied group, there was an increase in VAS in group 1 more than group 2 along the three sets of follow up with statistical difference between two studied groups in all follow ups as p-Value was &lt;0.05.

Conclusion
our data suggest that combined bilateral pudendal nerve block plus periprostatic nerve block is more effective than periprostatic nerve block alone in reducing the pain during TRUS guided prostate biopsy.
Role of MRI in Assessment of Central Nervous System Lesions and Post Treatment Complications in Pediatric Patents with Leukemia
Authors: Mohamed Hadeer Ramadan , Shawky Geneidi Eman Ahmed , Awadallah Shrouk Mohamed 
Published: July 2024

Abstract

Background
In terms of pediatric oncology, leukemia is one of the most frequent deadly illnesses. Early CNS problem identification and appropriate therapy were enhanced by MRI.

Aim
Describe the MRI results brought on by leukemia's involvement in CNS structures and treatment-related CNS side effects, and evaluate their efficacy for early therapy and preventing long-term adverse effects.

Patients and Methods
A prospective observational study included 52 children with leukemia. All patients undergone MR examination including conventional MRI, MR diffusion imaging and MR venography (MRV).

Results
Regarding MRI finding of CNS, leukemic infiltration was found in 57.7%, sub volimic changes in mild manner in 50% and about 26% in a moderate manner while absent in 23.1%, PRES was present in 19.2%, venous thrombosis present in 30.8% and post treatment complications were found in 7.7%.

Conclusion
Diffusion-weighted MRI proved very helpful in the early diagnosis and distinction of various CNS lesions seen in young patients with leukemia and post-treatment CNS sequelae. These techniques included conventional, post- contrast, MR venography, and diffusion-weighted MRI.
Role of Bowel Hydrosonography in Evaluation of Inflammatory Bowel Diseases Compared to CT or MR Enterography
Authors: Allam Khaled Esmat , Elia Remon Zaher , Ahmed Fouad Mohamed Hassan , Abd El Hafiz Rezk Essam Mohamed , El Aleem Mohamed Aya Tareaa Abd 
Published: July 2024

Abstract

Background
bowel diseases (IBD). CT entrography (CTE), bowel US, magnetic resonance enterography Crohn’s disease and ulcerative colitis are chronic, relapsing inflammatory (MRE) are decisive medical imaging modalities for diagnosing and locating bowel lesions with its extramural extent and complications. They assess the degree of activity, help clinicians to identify patients in need of surgery, and can be used for patient follow-up.

Aim
To evaluate the utility of small bowel hydrosonography (SBH) in assessment if patient s with proven IBD in comparison to the currently available CT/MR enterographic techniques.

Methods
The study was conducted on 41 patients with histologically proven IBD. All patients were subjected to clinical assessment, laboratory investigations, MRE/CTE then bowel ultrasound.

Results
This study was conducted on 41 patients (19.5%) with ulcerative colitis and (80.5 %) with Crohn's disease; Terminal illeum is the most affected detected segment (22.1%) by bowel ultrasound and(22.5%) by CTE/MRE, ultrasound also showed statistically significance results in detection evidence of complicated Crohn’s disease such as fistula and abscess.

Conclusion
In comparison to MRE/CTE, bowel hydrosonography is a useful, non- invasive, and feasible bedside imaging tool for the detection of inflammation, detection of complications, and follow-up of IBD patients.
Role of Endovascular Thrombectomy in Improving the Functional Outcome in Acute Stroke Patients Presenting 6-12 Hours after Stroke Onset
Authors: Elmahdy Abdalla Ramez Nader Mohamed , Guirguis Mounir Sobhy , Andsari Sameer A , Abdelsamad Amr Mahmoud , Soliman Ahmed Hassan 
Published: July 2024

Abstract

Background
Based on the World Health Organization (WHO) statistics, there are 15 million strokes annually. The aim of the treatment in acute ischemic stroke is rapid restoration of perfusion to the ischemic area by minimizing the time between the occurrence of symptoms and the treatment. This is crucial for saving the salvageable brain tissue (penumbra) by restoration of flow and metabolism to normal

Aim of Work
The aim of work is to evaluate the safety and efficacy of endovascular thrombectomy (EVT) in patients presenting 6-12 hours from onset of stroke symptoms secondary to large vessel occlusion.

Patients and Methods
50 Patients presenting with acute ischemic stroke with causative occlusion of major vessels in anterior circulation, underwent mechanical thrombectomy

Results
Two-thirds of the patients had their intracranial arterial occlusion at M1 segment of the middle cerebral artery. The median baseline NIHSS score, ASPECTS, and mRS score of the studied patients was 16 (IQR 11-20), 8 (IQR 7-9) and 0 (IQR 0-1), respectively. The median final infarct volume, NIHSS score, ASPECTS post-intervention and mRS score at 90 days of the studied patients was 40 ml (IQR 26.5-70) (P &lt; 0.001), 9 (IQR 4-16) (P &lt; 0.001), 8(IQR 5-9) (P &lt; 0.01), and 2 (IQR1-4) (P &lt; 0.001), respectively and (90 %) of them had revascularization type TICI 2b- 3. More than half of the studied patients (52%) had mRS score at 90 days of ≤ 2 and mortality rate was 12%.

Conclusions
The current study showed that endovascular thrombectomy techniques are safe and effective in the treatment of acute ischemic stroke.
Detection of Breast Cancer in Digital Mammograms by Using Artificial Intelligence
Authors: Hasan Ali Alshazly Hasan Hosameldeen , Guirguis Mounir Sobhy , Elshimy Ahmed Mohamed 
Published: July 2024

Abstract

Background
Daily reading of a large number of normal mammograms ni breast cancer screening programs is a tedious task reducing the attractiveness of the field. The advent of Artificial Intelligence (AI) in medical imaging could, however, provide means to improve the efficiency of mammography screening.

Objective
Our study aims to emphasize the role of AI system as an aid in detection of breast cancer in digital mammograms.

Patients and Methods
The main source of data for this study were the mammography studies on the picture archiving and communications system (PACS) of theradiology department, i n Shams university hospitals of the patients referred to the radiology department at Ain Shams university hospitals for screening mammography.

Results
Our study showed that the improvement in diagnosticperformance and reading times with AI support was observed for the radiologists who were least experienced with mammography while the Al is increased the reading times and had no effect on diagnostic performance on the more experienced radiologists.

Conclusion
Using the AI as an aid has proven to improve the overall performance of less experienced radiologists allowing them to reach expert like levels of diagnostic performance in the detection of breast cancer at mammography by using an AI computer system for support without the need for additional reading time.
Prevalence of Antiphospholipid Syndrome in Primary Budd Chiari patients and their intervention outcome
Authors: Sayed Farag Mahmoud Ahmed , Elsalam El-Folly Runia Fouad Abd , Hafez Eman Ahmed , Abo Elmaaty Mohamed El-Ghareeb , Fathy Badran Ethar Mokhtar 
Published: July 2024

Abstract

Background
Budd-Chiari syndrome (BCS) is a rare but potentially life threatening hepatic disorder that results from obstruction of the hepatic venous outflow tract. Obstruction can occur at any level from the hepatic venules to the right atrium. According to the etiology, BCS can be classified as primary (due to intrinsic intraluminal thrombosis or webs) or secondary (due to intraluminal invasion by a parasite or malignant tumor or extraluminal compression by an abscess, cyst or solid tumor) the clinical presentation of BCS has a wide spectrum and ranges from asymptomatic cases to fulminant hepatic failure The classic triad of abdominal pain, ascites, and hepatomegaly is nonspecific.

Aim of the Work
To assess the prevelance of Antiphospholipid syndrome (APS) in primary Budd Chiari syndrome (BCS) patients and their management outcome.

Patients and Methods
Patients presented to BCS outpatient clinic, Tropical medicine department, Ain Shams University Hospitals were enrolled in the study from 2005 to 2020. Some patients with APS have no evidence of any definable associated disease, while, in other patients, APS occurs in association with SLE or another rheumatic or autoimmune disorder. Traditionally, these have been referred to as primary or secondary APS, respectively.

Results
Regarding laboratory data, Lupus Anticoagulant, ACL IgG antibodies and ACL IgM antibodies were positive in 60 (83.3%), 49 (68.1%) and 27 (37.5%) patients respectively. For 42 patients (58.3%), intervention was performed. TIPSS was performed on 33 (45.8%) patients, while Angioplasty with Stent was performed on 9 (12.5%) patients. There was no intervention in 30 (41.7%) of the patients. In the studied patients, rate of mortality of the total 72 patients was 48.6%. The mean cause of death was Hepatorenal syndrome (31.4%).

Conclusion
BCS, although infrequent, is not a rare complication in patients with APS and may be the first clinical manifestation of this syndrome. However, no predisposing factor to BCS has been identified in patients with APS. This supports the need for systematic screening for LA and aCL in all cases of hepatic vein thrombosis. In these patients, TIPS placement may be an effective treatment for portal hypertension, but in any case, long-term high intensity anticoagulation treatment is essential in order to prevent recurrent thrombosis. Lupus anticoagulant is much more common than anticardiolipin antibodies (83.3%, 68.1% respectively) among BCS patients due to antiphospholipid syndrome.
Residual Stone Fragments after Percutaneous Nephrolithotomy: Shockwave Lithotripsy vs Retrograde Intrarenal Surgery
Authors: Shoeb Mohamed Shoukry , Radwan Ahmed Ibrahim , Atia Moustafa Diaa Eldin Mahmoud 
Published: July 2024

Abstract

Background
Post-PCNL treatment for 0.5-1.5 cm calculi is contentious. SWL has noninvasiveness, less anaesthetic, and improved subjective acceptability, but a lower stone-free rate and higher retreatment rate (RR). Retrograde intrarenal surgery (RIRS) is increasingly employed to treat after PCNL residual calculi with a greater success rate (SR), but with disadvantages of invasiveness and anaesthesia.

Aim
To compare the outcomes of retrograde intrarenal surgery (RIRS) to extracorporeal shockwave lithotripsy (SWL) for treating patients with RSFs after a previous standard PCNL.

Subject and Methods
A retrospective study of 70 adult patients with residual stone fragments after a standard PCNL submitted to RIRS or SWL (35 patients per each group) in ain shams university hospitals and police hospitals.

Results
There no significant difference between the groups regarding ASA, PCNL Guy’s classification, percutaneous tracts, stone composition and postoperative complications. There a significant difference between the groups regarding inferior calyx located stone and postoperative hospital stay. &gt;2 mm stones were significantly more frequent in SWL group compared to RIRS group.

Conclusion
From the findings of this study we can conclude that RIRS has better SFR for the treatment of RSFs after standard PCNL
Prognostic Ability of the Wound, Ischemia, Foot Infection (WIfI) Classification System in Diabetic Patients with Non-Healing Ulcer
Authors: Helmy Hanna Andrew Samy , Kamal Ashraf , Almegeed Mohammed Abd , Gamil Mina 
Published: July 2024

Abstract

Objectives
Several classifications have been published to predict limb salvage in diabetic patients with non-healing ulcer to aid in the management plan. The Society for Vascular Surgery (SVS) Lower Extremity Guidelines Committee has composed a new classification system that reflects the three major factors that impact amputation risk and clinical management Our goal was to evaluate the predictive ability of this wound, ischemia and foot infection(WIfI) classification as a predictor of limb salvage in diabetic patients with non-healing ulcer

Methods
a prospective single arm observational cohort study conducted on 50 patients within 2022 at single center, Ain Shams University Hospitals, Patients are diabetics who had non healing ulcers some of the cases underwent angioplasty or debridement, then follow up of the wounds was done. Limbs were stratified into clinical stages 1 to 4 based on the SVS WIfI classification for amputation risk.

Results
Our study included 38 males (76%) and 12 females (24%). The age range between 35 years and 73 years with mean age of 59±8.81. All of the patients are diabetic. The percentage of patients with hypertensive ( 76 %), 54% of them were smoker & 7 were suffering from ESRD. limb salvage was achieved on 75 % of cases. All cases have been classified according to WIFI classification into clinical stages I-IV and their percentage were 6%,12%,40% and 42% respectively. WIfI classification was significant in predicting the major or minor amputation as well as ulcer healing. As Major amputation among each WIfI classification group low, moderate and high risk was 0%, 10%, 47% respectively. Risk of minor amputation was 22%, 40% and 76% respectively. While ulcer healing was 100%, 85% and 52% respectively.

Conclusion
The likelihood of an amputation after one year in patients with non healing ulcer increases with higher WIfI stages, so The WIfI classification is applicable in prediction of limb salvage in diabetic patients with non-healing ulcer. Smoking and aging also decreases the chance of limb salvageability