bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased serum ferritin is associated with severity of orbital disease in COVID-19–associated rhino-orbito-cerebral mucormycosis: A quantitative analysis
Authors: Tanwar Shashi , Mishra Nibha , Sharma Prachi , Kaur Apjit 
Published: July 2024

Context:
Effect of serum ferritin on severity of coronavirus disease 2019 (COVID-19)-associated rhino-orbito-cerebral mucormycosis.

Purpose:
To study the association between increased serum ferritin and severity of orbital disease in COVID-19–associated rhino-orbito-cerebral mucormycosis.

Settings and Design:
A cross-sectional study.

Methods:
Hundred (n) out of 155 treatment-naive patients of COVID-19 infection presenting with the signs and symptoms of rhino-orbito-cerebral mucormycosis were enrolled in study. Based on the classification proposed by Honavar, the study patients were classified into four stages: Stage 1: involvement of the nasal mucosa (n = 11), Stage 2: involvement of paranasal sinuses (n = 14), Stage 3: involvement of the orbit (n = 37), Stage 4: involvement of the central nervous system (n = 38). Stage 3 was further divided into four substages: 3a: nasolacrimal duct, medial orbit, vision unaffected (n = 4); 3b: diffuse orbital involvement (>1 quadrant or >2 structures), vision unaffected (n = 15); 3c: central retinal artery occlusion or ophthalmic artery occlusion, superior ophthalmic vein thrombosis, involvement of superior orbital fissure, inferior orbital fissure, orbital apex, diminution or loss of vision (n = 13); 3d: bilateral orbital involvement (n = 5). Fasting blood sugar (FBS), postprandial blood sugar (PPBS), and inflammatory markers (serum ferritin, interleukin-6, C-reactive protein, and D-dimer) were assessed. Serum level of ferritin was analyzed by using chemiluminescence immunoassay method.

Results:
Mean FBS (mg/dl) was 165.03 ± 70.43 for stage 1, 185.67 ± 64.82 for stage 2, 159.05 ± 68.60 for stage 3, and 158.20 ± 62.05 for stage 4. Mean PPBS (mg/dl) was 238.70 ± 141.29 for stage 1, 252 ± 103.69 for stage 2, 257.09 ± 103.48 for stage 3, and 229.53 ± 76.81 for stage 4. Mean serum ferritin (μg/l) was 302.67 ± 266.95 in stage 1, 444.19 ± 116.36 in stage 2, 504.85 ± 205.99 in stage 3, and 825.95 ± 777.30 in stage 4. A statistically significant increase in serum ferritin levels with severity of disease (P = 0.005) was noted. Similar trend was observed in substages of stage 3. Pearson correlation analysis showed a positive correlation between serum ferritin and severity of disease (P = 0.0007).

Conclusion:
Increased serum ferritin was significantly independently associated with severity of orbital disease in COVID-19–associated rhino-orbito-cerebral mucormycosis.
Efficacy of gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in patients with primary open-angle glaucoma and pseudoexfoliative glaucoma: A single surgeon’s experience
Authors: Cakir Ihsan , Balci Ali Safa , Alagoz Nese , Yalcinkaya Cakir Gülay , Altan Cigdem , Yasar Tekin 
Published: July 2024

Abstract

Purpose:
To compare the intraocular pressure (IOP)-lowering efficiency of gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) with mitomycin C in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG).

Methods:
In this retrospective comparative study, consecutive patients with POAG or PEXG who underwent GATT or TRAB by a single surgeon and with a follow-up period of at least 1 year were included. Surgical success rates, change in best-corrected visual acuity, IOP, the need for antiglaucoma medication, surgical complications, and the need for additional glaucoma surgery were compared. Surgical success was defined as an IOP reduction of ≥30% or an IOP of ≤18 mmHg. Complete success was defined as without medication. Qualified success was defined as with or without topical medication.

Results:
The mean baseline IOP was 27.4 ± 8.3 and 24.6 ± 7.6 mmHg (P = 0.13) with the mean number of medications being 3.7 ± 1.0 and 3.7 ± 1.1 (P = 0.98) in TRAB and GATT, respectively. At 12 months, the mean IOP was 15.3 ± 3.5 and 12.5 ± 4.6 mmHg (P = 0.24) with the mean number of medications being 0.9 ± 1.2 and 0.8 ± 1.4 (P = 0.76) after GATT and TRAB, respectively. IOP was lowered from baseline by 52.7% ± 17.5% after TRAB and 45.7% ±18.6% after GATT (P = 0.12). There was no decrease in best-corrected visual acuity in either group. The qualified surgical success rate was 94.4% in the GATT group and 94.9% in the TRAB group (P = 0.75). Percentage of complete success was 64.1% and 52.8% (P = 0.22) after TRAB and GATT, respectively.

Conclusion:
In patients with POAG and PEXG, GATT was as effective and safe as TRAB in lowering IOP and reducing the number of antiglaucomatous drugs.
Short-term outcomes of Tanito microhook ab interno trabeculotomy combined with phacoemulsification in primary open-angle glaucoma – A pilot study
Authors: Sasidharan Ajita , Shah Paraali , Thulasidas Mithun 
Published: July 2024

Purpose:
The aim of the study was to assess the early postoperative efficacy and safety of Tanito microhook (TMH) ab interno trabeculotomy combined with phacoemulsification in patients with primary open-angle glaucoma (POAG).

Methods:
This prospective interventional study was conducted on consecutive patients with visually significant cataract and mild-moderate POAG. All patients underwent a temporal clear corneal phacoemulsification combined with TMH ab interno trabeculotomy. Postoperative evaluation was done on day 1, 1 month, and 3 months. The outcome measures included intraocular pressure (IOP) at different follow-ups and postoperative complications.

Results:
In total, 30 eyes of 30 patients were included in the study. There were 16 (53.3%) females and 14 (46.7%) males with a mean age of 62.63 ± 6.7 years. The mean IOP reduced from 23.57 ± 1.65 to 17.33 ± 2.84 at 3 months (P < 0.001). All eyes had a corrected distance visual acuity ≥6/9 at 1 month postoperatively. Postoperative complications included corneal stromal edema in eight (26.7%) eyes, hyphema in four (13.3%) eyes, and IOP spike in one (3.3%) eye.

Conclusion:
TMH ab interno trabeculotomy combined with phacoemulsification in patients with mild-moderate POAG is an effective and safe procedure with fewer complications.
Combined corneal biomechanical and tomographical indices in subclinical and forme fruste keratoconus
Authors: Ganesh Meghna , Arora Ritu , Titiyal Jeewan S 
Published: July 2024

Purpose:
Evaluation of combined corneal tomographic and biomechanical parameters in subclinical/forme fruste keratoconus (ScKC/FFKC).

Design:
Cross-sectional observational case-control study.

Methods: Inclusion Criteria:
Thirty-one eyes with ScKC (fellow eye of KC with any one sign: keratometry >47 diopters, cylinder >1.5 D, central corneal thickness <500 µm, with/without abnormal topography) or FFKC (fellow eye of KC with normal topography and slit lamp examination) >13 years (cases) and 44 eyes of age-matched 22 healthy subjects (controls).

Exclusion Criteria:
Clinically diagnosed KC, presence of corneal scars, and prior ocular surgery eyes.

Study Parameters:
Sixteen Pentacam, 15 Corvis ST, and five Sirius parameters were analyzed using paired sample t-test, and a subsample found to be significantly different was used in receiver operating characteristic curve analysis. The Youden index was calculated, and Pearson’s correlation analysis was done.

Results:
Five Pentacam, three Corvis ST, and two Sirius parameters had an area under curve (AUC) >0.75. Tomographic and biomechanical index (TBI) (cutoff 0.59, 95% specificity, 77% sensitivity), Belin Ambrosio enhanced ecstasia display (cutoff 1.8, 81% specificity, 80% sensitivity), and symmetry index of posterior corneal curvature (cutoff 0.16, 97% specificity, 67% sensitivity) best identified early KC. TBI strongly correlated with maximum Pentacam parameters in both cases and controls. Corvis biomechanical index strongly correlated only in cases, and SP-A1-SD weakly correlated in cases.

Conclusion:
Upon combined analysis, the average sensitivity and specificity, respectively, of top three parameters (according to AUC) from Pentacam and Corvis ST were 74.1% and 95.4% for posterior elevation and TBI.

Trial Registration:
The trial was registered in Clinical Trial Registry of India on January 28, 2022. The Trial Registration Number is REF/2022/01/050638.
The Association between Number of Follicular Stelae and Severity and Treatment Response of Alopecia Areata Cases: A Retrospective Study
Authors: Gencebay Güllü , Aşkin Özge , Aydin Övgü , Serdaroğlu Server 
Published: July 2024

ABSTRACT

Background:
Alopecia areata (AA) is an autoimmune disease characterized by peribulbar lymphocytic infiltration, follicular miniaturization, catagen/telogen follicles, and increased follicular stelae (streamers) in skin biopsies.

Objectives:
Our aim was to assess the number of follicular stelae of patients with AA and to evaluate their association with clinical type and severity and treatment response of AA.

Materials and Methods:
Histopathologic features including the number of follicular stelae were recorded in skin biopsies taken from lesions of AA in 142 patients who attended our dermatology clinic from 2011 to 2017.

Results:
There was a statistically significant correlation between patient age and the number of follicular stelae (P = 0.001). There was a statistically significant correlation between the severity of disease and number of follicular stelae (P = 0.005). AA subtypes (0%–25% scalp hair loss) had a significantly lower number of follicular stelae than 75%–100% of scalp hair loss and alopecia universalis (7.92 ± 4.21 vs. 13.23 ± 7.28). There was no statistically significant correlation between treatment response and the number of follicular stelae (P = 0.75).

Conclusion:
Our results showed that the number of follicular stelae varied among AA clinical types and correlated with severity. This study was the first to evaluate the correlation between the number of follicular stelae and severity of AA.
Trichoscopy in Trichotillomania – Monitoring Treatment Response
Authors: Srisukhirthi S. , Kuruvila Sheela , Ramamurthy Parthasarathy 
Published: July 2024

ABSTRACT
Trichotillomania is nonscarring alopecia with recurrent pulling out of one’s hair and repeated attempts to reduce hair pulling. Clinical improvement in the urge to pull out hairs in trichotillomania is often not quantifiable and based on unreliable history. Here, we present a case of trichotillomania with follow-up features on trichoscopy during treatment. By this, we propose trichoscopy as an objective tool to visualize clinical improvement in the urge to pull out hairs and assess treatment efficacy.
Functional Outcome of Patients with Malignant Tumors around the Knee Treated by Modular Endoprosthesis: A Comparative Study between Patellar Resurfacing and Nonresurfacing
Authors: Ebeid Walid Atef , Mehanna Mohamed Taha A. , Moustafa Mohamed Saleh , ElNasr Khaled Mohamed Ahmed Abo , ElFadl Sameh Mahmoud Abo 
Published: July 2024

Abstract

Background:
Patellar resurfacing with knee arthroplasty has always been controversial. The literature contains data that support both resurfacing and not resurfacing the patella. However, the literature does not review a lot of studies that address the impact of patellar resurfacing on the functional outcome following resection of distal femur tumors and limb salvage using modular prosthesis.

Questions/Purposes:
Is patellar resurfacing better than nonresurfacing as regards functional outcome of modular prosthesis used for the treatment of tumors around the knee?

Patients and Methods:
Two groups of patients; both were subjected to wide excision of tumors around the knee and limb salvage using modular prosthesis. The first group underwent reconstruction with patellar resurfacing, while the second underwent reconstruction without patellar resurfacing. The age of these groups of patients ranged from 11 to 71 years. The patients were 17 males and 19 females. We evaluated patients using the musculoskeletal tumor society scoring system (MSTS), knee society final score, knee society function score, and anterior knee pain score.

Results:
We found that MSTS functional score, knee society final score and knee society function score, and anterior knee pain score were all better in patients who underwent patellar resurfacing compared to nonresurfacing patients. However, only the difference in anterior knee pain score was statistically significant (P = 0.030). Differences in other scores between these two groups were all statistically insignificant (P value of the MSTS difference = 0.103, P value of the knee society final score difference = 0.423, and P value of the knee society function score difference = 0.337).

Conclusions:
Patellar resurfacing could be helpful in decreasing anterior knee pain and the necessity to future surgeries addressing patellofemoral pain, especially in revision cases, patients with patellofemoral problems, and patients with extensor mechanism weakness and those with anterior knee pain. Since Anterior Knee Pain Scale was the only scoring system, among all scoring systems used, that confirmed a significant impact of patellar resurfacing on the outcome following resections and reconstructions; we cannot give an explicit strong recommendation favoring the routine patellar resurfacing in all cases undergoing resections and reconstructions using modular prosthesis. We recommend patellar resurfacing in older patients, based on our results, which show possible benefit of patellar resurfacing in older patients. We think that old age and the preexisting knee arthritis could be relative indications for patellar resurfacing.
Short-Term Results after Reverse Total Shoulder Arthroplasty
Authors: Shoukry Mahmoud , El-Rhaman Amr Ahmed Abd , Abdelazim Haytham , Khater Ahmed Hany , El-Wahab Mahmoud M. Abd , Abouelsoud Maged 
Published: July 2024

Abstract

Background:
The loss of the shoulder’s center of rotation is caused by massive rotator cuff tears, which can occur with or without arthritis and proximal humerus fractures that are nonunion or malunion. Because anatomical total shoulder arthroplasty cannot provide a stable center of rotation, reverse total shoulder arthroplasty (RTSA) is the appropriate procedure for these indications and in older patients who have primary glenohumeral osteoarthritis. Anatomical total shoulder arthroplasty carries a risk of failure because of the loosening of the glenoid component or cuff tear. The purpose of this study was to determine the short-term outcomes following RTSA in patients who had primary glenohumeral osteoarthritis, acute proximal humerus fractures, malunited or nonunited proximal humerus fractures, and massive cuff tears.

Materials and Methods:
This single-arm clinical trial (interventional study) was done in Ain Shams University Hospitals; 16 patients were included who underwent RTSA. Constant score, American Shoulder and Elbow Surgeon score, Visual Analog Scale score, and range of motion (ROM) were the short-term outcomes. Patients with cuff tear arthropathy, irreparable cuff tear with or without glenohumeral arthritis, elderly patients with unreconstructable proximal humerus fracture, proximal humerus fracture malunion or nonunion, and patients with glenohumeral osteoarthritis were included. Patients under the age of 50, as well as those with deltoid muscle dysfunction or injuries to the axillary nerve, were excluded.

Results:
There were 16 patients in this study, 8 of whom were male and 8 of whom were female. The follow-up period lasted 2 years following surgery, with a mean age of 64.19 years. The study included 7 patients with irreparable cuff tears one of them had associated anterior shoulder instability and recurrent anterior shoulder dislocation. One patient had a neglected shoulder dislocation, two patients had proximal humerus fracture dislocation, two patients had a nonunited proximal humerus fracture, three patients had unreconstructable proximal humerus fracture, and two had glenohumeral osteoarthritis.

Conclusion:
Not only did RTSA provide good clinical and functional outcomes for the standard indication of a massive cuff tear, but it also proved beneficial for other disorders such as primary glenohumeral osteoarthritis, nonunited fracture, and acute proximal humerus fracture. Among all indications, irreparable cuff tears yielded the highest results; nonunited fractures displayed the least improvement regarding clinical outcomes. Enhancements in the design of prostheses, the expertise of surgeons, and clinical outcomes are crucial to maximize their effectiveness in treating various shoulder disorders.
Arthroscopically Assisted Technique in the Treatment of Ankle Fractures with Posterior Malleolus Fragment in Adults
Authors: Elhabet Mohamed Atef Mohamed , Abo-Elnasr Khaled Mohamed , Henawy Ayman Tawfik , Metwally Ahmed Mahroos , Toreih Ahmed Aly 
Published: July 2024

Abstract

Introduction:
Ankle fractures constitute a challenging condition due to its high impact on the long term. Thus, advancements in management have been proposed to ensure the best possible outcome. Hence, we aimed to assess the role of arthroscopy in the treatment of ankle fractures that involve posterior malleolus fragments in adults.

Patients and Methods:
In a quasi-experimental, interventional, prospective, nonrandomized study, we included 16 adult patients with acute ankle fracture with posterior malleolus fragment. They underwent arthroscopically assisted technique for their fracture treatment. A standard systematic arthroscopic ankle examination, their fracture grade, and classification were assessed, and subsequent management was conducted. The patients were followed up for 6 months using the American Orthopedic Foot and Ankle Society (AOFAS) score and radiographic monitoring with standard X-ray.

Results:
The mean AOFAS score improved significantly after 6 months of follow-up (from 84.81 in the 3rd month to 92.81 in the 6th month). Ankle dorsiflexion angle and ankle plantar-flexion angle showed a gradual increase during follow-up, reaching 17.31° ± 3.25° and 45° ± 5°, respectively. Only two patients developed complications. Age, body mass index, and grade of the osteochondral lesion were negatively correlated statistically significantly with the AOFAS score. This proves the effective role of arthroscopically assisted technique in the treatment of ankle fractures with posterior malleolus fragment.

Conclusion:
Arthroscopically assisted technique in the treatment of ankle fractures with posterior malleolus fragment in adults resulted in good functional outcomes with less complications and it allows the assessment of associated intra-articular injuries. Further studies with longer follow-up periods are needed for the assessment of outcomes and complications for comparison.
Trabecular Metal Augments for Reconstruction of Acetabular Bone Defects in Revision Total Hip Replacement: Short-Term Outcomes
Authors: El Axir Husam M. , Alashhab Mohamed G. , Khater Karim S. 
Published: July 2024

Abstract

Background:
Revision hip surgeries are increasing dramatically nowadays, and achieving hip center of rotation is challenging. Obtaining a press-fit implant and restoring the hip’s center of rotation might be difficult during the restoration of acetabular deformities during revision total hip arthroplasty (THA).

Aim:
The aim of the study was to evaluate the outcomes of using trabecular metal augments for reconstruction of the acetabulum in patients undergoing revision THA with short-term follow-up.

Patients and Methods:
This study was conducted in Benha University Hospital between April 2019 and March 2023. It is a prospective cohort study including 20 patients who are undergoing revision THA with acetabular defects.

Results:
The mean age of patients in this study was 59 years old. According to Paprosky classification: 45% of type 2B. The postoperative Oxford Hip Score showed marked improvement in the outcomes, the score was excellent in 55% (11 patients), good in 40% (8 patients), and fair in only 5% (1 patient) over 16 months’ mean follow-up period.

Conclusion:
Due to its modularity, tantalum augments are considered a valuable method in the reconstruction of acetabular defects.
Calculation of Organ Dose Distribution (in-field and Out-of-field) in Breast Cancer Radiotherapy on RANDO Phantom Using GEANT4 Application for Tomographic Emission (Gate) Monte Carlo Simulation
Authors: Behmadi Marziyeh , Toossi Mohammad Taghi Bahreyni , Nasseri Shahrokh , Ravari Mohammad Ehsan , Momennezhad Mahdi , Gholamhosseinian Hamid , Mohammadi Mohammad , Mdletshe Sibusiso 
Published: July 2024

Abstract

Introduction:
Organ dose distribution calculation in radiotherapy and knowledge about its side effects in cancer etiology is the most concern for medical physicists. Calculation of organ dose distribution for breast cancer treatment plans with Monte Carlo (MC) simulation is the main goal of this study.

Materials and Methods:
Elekta Precise linear accelerator (LINAC) photon mode was simulated and verified using the GEANT4 application for tomographic emission. Eight different radiotherapy treatment plans on RANDO’s phantom left breast were produced with the ISOgray treatment planning system (TPS). The simulated plans verified photon dose distribution in clinical tumor volume (CTV) with TPS dose volume histogram (DVH) and gamma index tools. To verify photon dose distribution in out-of-field organs, the point dose measurement results were compared with the same point doses in the MC simulation. Eventually, the DVHs for out-of-field organs that were extracted from the TPS and MC simulation were compared.

Results:
Based on the implementation of gamma index tools with 2%/2 mm criteria, the simulated LINAC output demonstrated high agreement with the experimental measurements. Plan simulation for in-field and out-of-field organs had an acceptable agreement with TPS and experimental measurement, respectively. There was a difference between DVHs extracted from the TPS and MC simulation for out-of-field organs in low-dose parts. This difference is due to the inability of the TPS to calculate dose distribution in out-of-field organs.

Conclusion and Discussion:
Based on the results, it was concluded that the treatment plans with the MC simulation have a high accuracy for the calculation of out-of-field dose distribution and could play a significant role in evaluating the important role of dose distribution for second primary cancer estimation.