bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antiepileptic Drugs as Prophylaxis for Seizures after Excision of Brain Tumors
Authors: Ashour Ahmed Maamoun , Fayed Zeiad Yossry , Sabry Ismail Ismail Hassan , Sherif Agiez Mostafa Ahmed 
Published: July 2024

Abstract

Background
Seizures are the most common & most serious side effect of cranial surgery. The latter condition requires chronic treatment with Antiepileptic drugs (AEDs) and comes with relevant socioeconomic sequelae. The routine prophylactic use of AEDs for people undergoing tumor resection has remained controversial due to the risk of postoperative seizures. Some Neurosurgeons are advocates to the use of AEDs to reduce the risk of these seizures.

Objective
To evaluate the efficacy of prophylactic AEDs routinely in brain tumor patients without previous history of seizures. Primary objective has been to identify the efficacy of AEDs in perioperative seizure prophylaxis. Secondary objective has been to highlight the most common type of post-operative AEDs.

Methods
All available studies from 2000-2021 including randomized or non-randomized clinical trials, prospective or retrospective observational cohort studies, and case series of six or more cases that address these criteria have been collected.

Results
Our search concluded that the most common type of post-operative seizure is the Early seizure which is of total 87 patients representing 12.3% of seizure reported patients, yet when comparing the P-value between the Early & late seizure it has a P-value of 0.415 which is nonsignificant rendering the comparison redundant. The Most common types of AED used are Phenytoin (PHT) 89 (71.8%) & Levetiracetam (LEV) 109 (81.8%). To measure the efficacy of AEDs two groups of patients with no history of AED administration or seizures preoperatively were created, one the control group of 268 participants were not administered AEDs postoperatively only 32 (11.94%) of them suffered from seizures postoperatively. The other group of 171 participants were administered the AEDs postoperatively only 25 (14.62%) of these participants suffered from postoperative seizure. Comparing both of these results statistically it had a P-value of 0.416 which is non-Significant statistically. On interpreting these results was that the AED have no influence in controlling the seizures.

Conclusion
Postoperative seizures are one of the main complications of brain tumor surgery. Neurosurgeons have a strong belief more of tradition that preventing seizures with Anti-Epileptic Drugs (AEDs) as a sort of seizure prophylaxis is not only effective but also necessary. Finally, there is not enough evidence of sufficient quality available to suggest that antiepileptic drugs AEDs treatment can or cannot be recommended to reduce Post-craniotomy seizures.
Vagus Nerve Stimulation for Intractable Focal Epilepsy
Authors: Habib Mohamed A , Talat Mohamed A , Ibrahim Amr Galal , Elgalab Mohamed H 
Published: July 2024

Abstract

Background
Epilepsy is a common neurological condition affecting 0.5-1% of the population. Despite the advances in the medical management of epilepsy 25-35% of patients have poor control of their seizures or have unacceptable side effects from the medication.

Aim and Objectives
To make up-to-date recommendations for the value of vagus nerve stimulation (VNS) in patients suffering from intractable focal epilepsy and not candidates for surgical resection.

Subjects and Methods
Eight studies were included in the present meta-analysis. The flow diagram of the study selection processes. The total number of patients in the eight included studies was 266. The follow-up periods ranged from 12–124 months. Because of significant heterogeneity (I2 = 94 %) among the included studies, a sensitivity analysis was performed.

Result
59.4% of all the included patients showed a 50% or greater reduction in seizure frequency after VNS. The patients with &gt; 50% reduction in seizure frequency ranged from 25–66% among the eight included studies. Non-significant improvement in seizure frequency after VNS.

Conclusion
After VNS, the frequency of seizures was reduced by 50% in about 59.4% of the patients with intractable focal seizures. The present study's random effects forest plot, however, indicated that the reduction in seizure frequency following VNS was not statistically significant. The effectiveness of VNS in reducing seizure frequency in the population under study is therefore still unknown,.
Prospective Study to Assess the Clinicopathological and Prognostic Value of BRAF V600E Mutation in Metastatic Colorectal Cancer
Authors: ELsaeed Mona Taher , ELwakeel Hisham M , Mostafa Mohamed Y , Shakweer Marwa M , Elghamry Wesam R 
Published: July 2024

Abstract

Background
BRAF is a protein kinase downstream of RAS in the RAS-RAF-MEK- ERK kinase pathway. The majority (&gt;95%) of BRAF mutations in metastatic colorectal cancer (mCRC) is the BRAFV600E mutation, which is considered an important negative prognostic marker and is associated with resistance to standard chemotherapies in mCRC patients.

Objectives
This study aimed to investigate the BRAF mutation in patients with mCRC and its association with clinicopathological factors and survival outcomes.

Patients and Methods
The included specimens were analysed for BRAFV600E mutation by immunohistochemistry (IHC) from confirmed CRC patients with radiological or pathological evidence of metastasis.

Results
The BRAF mutation was positive in 9.1% of patients. Synchronous metastasis was observed in patients with BRAF mutation with statistical significance (P = 0.033). With regard to treatment, there was no statistically significant difference in patients with BRAF mutations who received targeted chemotherapy as first-line therapy also there was no statistically significant difference in median PFS of patients with BRAF mutation (p = 0.789) and also in median OS (p = 0.343).

Conclusion
Although the BRAF mutation is a relatively rare finding in mCRC, it is characterized by a critical negative impact on treatment outcome. Given this poor outcome, optimization of therapy is an important goal.
Value of Anterior Segment Ocular Coherence Tomography (AS-OCT) in Dryness Evaluation in Vitiligo
Authors: Elgendy Zainab , Zaher Fikry , Shafik Ahmed , ElSherif Radwa 
Published: July 2024

Abstract

Background
Vitiligo is an acquired depigmentation disorder of the skin and mucous membranes with an autoimmune proposed pathogenesis. The concurrence of vitiligo and ocular abnormalities has been investigated in different studies, some of which have focused on ocular surface and dry eye evaluation in vitiligo.

Aim of the Work
Our study aimed at evaluating the tear film changes in patients with vitiligo using clinical assessment, severity indices and AS-OCT, and comparing these findings with healthy matching controls.

Patients and Methods
A case control observational study that included 60 eyes (the right eye of 30 patients with vitiligo and the right eye of 30 healthy age and sex matched controls). For every patient full dermatological assessment was done and drug history taken. Every study subject was evaluated regarding their dry eye symptomatology using the (OSDI) score questionnaire, clinical effect of dry eye in various tests (Schirmer’s test, TBUT, CFS using Oxford scheme), and using the AS OCT in measuring tear film height.

Results
We found that vitiligo patients had a lower tear film height when compared with controls (but statistically insignificant). Patients with vitiligo were more symptomatic regarding their dry eye symptoms assessed by OSDI score, they had a shorter tear breakup time than the control group, and a higher CFS grade using Oxford scheme indicating tear film instability.

Conclusion
Our study revealed lower, but statistically insignificant TFH as compared to the control group. TBUT was shorter, CFS was more evident and Schirmer’s test (although did not reach statistical significance) was shorter in vitiligo patients which revealed a tendency for dry eye syndrome. Supporting these findings, the OSDI score was higher in vitiligo patients. These results indicated worse symptomatology of dry eye in vitiligo patients and lack of stability of their tear film. The findings were supported by multiple previous studies mentioned earlier.
Efficacy of Indirect Laser Photocoagulation in Cases with Retinopathy of Prematurity Presenting with Late Stage 3 Turning into Stage 4A
Authors: Al-Feky Mariam 
Published: July 2024

Abstract

Background
Retinopathy of prematurity (ROP) is a preventable irreversible cause of blindness in children especially in developing countries. Early detection and management of type 1 ROP with intravitreal injection of Anti-VEGF or indirect laser photocoagulation is the cornerstone of preventing blindness from this disease. Screening programs for ROP are mandatory for picking cases early before retinal detachment develops. Standardized screening programs are still lacking in developing countries, like Egypt, so cases may present in later stages. Cases presenting too late with Stage 4 and 5 ROP are managed surgically with lens-sparing vitrectomy or lensectomy vitrectomy. A portion of the cases present at the transition from stage 3 into stage 4a ROP. Management of those cases with intravitreal anti-VEGF was reported to cause acute crunch and tractional retinal detachment. Management with laser photocoagulation has not been discussed before.

Methods
This is a retrospective interventional, non-comparative study. Review of records of ROP cases presenting after 4 weeks from delivery having stage 3 turning into stage 4a ROP for which indirect laser photocoagulation was done were collected in the period from January 2017 till May 2019. Gestational age, birth weight, postmenstrual age at first presentation, date of laser photocoagulation and number of sessions, fundus images showing initial regression and final regression and if any recurrences happened were recorded.

Results
Nine treatment naive eyes of five premature infants were included. Mean GA was 30.4+/- 1.5 wks (range, 28-32 wks; median, 31). Mean BW 1190+/- 174.6 gm (range, 900-1300; median = 1300). Mean PMA at presentation 42.5+/-5.7 wks (range, 38.5-52.5; median, 40.5). All 9 eyes presented with plus disease and highly elevated fibrovascular ridge with significant fibrous component in Zone II. 7 eyes (77.7%) had secondary retinoschisis, localized tractional retinal detachment. 2 eyes (22.2%) showed temporal dragging. All eyes received Indirect laser photocoagulation to the avascular retina (near confluent burns) one session for each eye. No skip areas were reported. 5 eyes (3 patients) were done under topical anesthesia and 4 (2 patients) under general anesthesia. All 9 eyes (100%) showed complete regression of ROP with release of traction, restoration of retinal anatomy at a mean of 3.7+/- 2.7 months (range, 2-8.5 months; median, 2.5 months).

Conclusion
Indirect laser photocoagulation is an effective treatment measure in premature infants presenting late with fibrovascular proliferation having high fibrous components and starting Stage 4a ROP in Zone II. Laser rather than IVI of Anti-VEGF may save those infants from crunch phenomenon and need for vitrectomy with final good anatomical and thus visual outcomes.
Outcomes of Intra-Articular Procedures through Safe Surgical Hip Dislocation Approach to Manage Residual Hip Deformities Secondary to Legg-Calv-Perthes Disease: A Systematic Review and Meta-Analysis
Authors: Gebeily Mohamed E L , Rayan Ahmed , Mohamed Salah Mohamed Mohamed 
Published: July 2024

Abstract

Background
Legg-Calve-Perthes disease (LCPD) is a childhood condition characterized by femoral head osteonecrosis. The osteonecrotic lesion eventually heals, but persistent deformity to the proximal femur and acetabulum might induce hip discomfort and dysfunction following recovery. Previous reports have noted that between 30% and 50% of individuals affected by LCPD to have residual hip symptoms that persist and a frequent precursor to hip osteoarthritis in young adulthood.

Aim of the Work
The aim of the present study is to review the efficacy of intra-articular procedures through surgical hip dislocation approach to residual hip deformity secondary to Legg- Calve-perthes disease.

Patients and Methods
A Systematic Review and Meta-Analysis, We will include: Randomized control trails (RCTs), controlled clinical trials, retrospective cohort studies and we will exclude: case reports, case series studies, cross sectional studies and non English studies.

Results
The surgical hip dislocation approach allows the surgeon to dynamically evaluate the hip, identify sources of impingement, and treat intraarticular and extraarticular abnormalities.

Conclusion
Head and neck osteochondroplasty performed through the surgical dislocation approach, combined with other procedures such as FHRO, RFNL, ITO and acetubular osteotomies relieved pain, improved ROM and restored function in most patients with no major complications.
Volar versus Dorsal Plating for Fracture Distal Radius (A Systematic Review/Meta-Analysis)
Authors: Diab Ramy Ahmed , Mohamed Amr Moustafa , Razmy Rophael Mina Mansour 
Published: July 2024

Abstract

Background
Fractures of the distal radius are the most common of all orthopedic injuries accounting for nearly 16–20% of all fractures presenting to the emergency department. Treatment of distal radius fractures historically has been predominantly by inexpensive means as some surgeons advocate treatment by manipulation and plaster immobilization.

Aim of the Work
This study aims to review systematically and to meta-analyze the currently available literature regarding volar and dorsal plating for distal radial fractures regarding functional outcome and complications.

Patients and Methods
This study was approved by the Ethical Committee of Ain Shams University Faculty of Medicine. Written informed consent was not needed because of the study design(systematic review).

Results
The results of our study showed that there were significant difference between volar and dorsal groups regarding ROM (Flexion, Extension, Ulnar deviation and Radial deviation). Also we found significant difference regarding PRWE Score, DASH Score and complication rate. Also the results showed non significant difference between volar and dorsal plating groups regarding VAS Score for Pain, Grip Strength and ROM (Supination and Pronation). We also found the dorsal fixation offers a lower risk of neuropathy and carpal tunnel syndrome than the volar fixation, But a higher risk of tendon irritation and rupture in dorsal group so we recommend removal of dorsal plates after good healing and regain good range of motion.

Conclusion
In conclusion, Based on our outcomes of current systematic review and meta-analysis, it appears that fractures of distal radius treated previously with dorsal plating showed poor outcomes and unclear results, meanwhile more recent studies favored volar plating for fixation compared to indicated dorsal plating biased by these studies.
A Systematic Review & Meta-Analysis on Criteria for Transcranial Motor Evoked Potential for Intraoperative Neuromonitoring during Spine Surgeries
Authors: Ahmed Abdelrahman Wagdy , Elsayed Mohamed Nabil , Elzahlawy Hany Nabil 
Published: July 2024

Abstract

Background
Spine Surgery is the definitive treatment and indication for many traumatic spine illnesses, as well as several pathologies and deformities. Surgery in such a vital organ, formed in its core of the neural pathway that controls the whole of the human body, must be as safe, and least risky as possible, so as to prevent injuries to the neural pathway, or the surrounding vessels, or vital organs. Such great importance of the spine and the spinal cord, has urged surgeons and researchers to create techniques through which spine surgeries are well monitored, and the efficacy and normal physiology is well assessed intraoperatively.

Objective
to conduct a systematic review and meta-analysis of what has been published of the studies using transcranial motor evoked potential for intraoperative neuromonitoring during spine surgeries. This is for acquiring the best criteria for transcranial motor evoked potential (TcMEP) utilization for intraoperative neuromonitoring, as well as identifying the most accurate alarm point for TcMEP during intraoperative neuromonitoring.

Patients and Methods
a comprehensive and detailed search of literature was conducted through the Pubmed, Google Scholar, and Research Gate databases including articles related to intraoperative neuromonitoring modalities and transcranial motor evoked potential alarm points and criteria. Searches were performed with a combination of MeSH (medical subject headings). Only Studies published in the English Language with no lower date limit were included. The following search string was used in all databases; (“Intraoperative Neuromonitoring” or “Transcranial Motor Evoked Potential”).

Results
In a prospective study conducted in 2018, performed on 2867 patients, using a 70 % decrease in amplitude of the TcMEP curve as an alarm point during high-risk spinal surgeries, the number of true positive to false positive cases was found to be 126/234, while the number of true negative cases to false negative cases was found to be 2362/9 cases in total. The study demonstrates the necessity of intraoperative neuromonitoring for high-risk spinal surgery. 136 cases in this study were identified as rescue cases, as intraoperative TcMEP alert occurred and intraoperative maneuverings were done to overcome those alerts, hence hindering occurrence of postoperative neural deficit.

Conclusion
As regards different TcMEP alarm point values, it has been concluded that an alarm point of 50-60% decrease in amplitude of TcMEP is a more sensitive alarm point, than a higher value alarm point of the same modality. An alarm point of &gt; 70% decrease in amplitude has a much less sensitivity value than lower alarm points, which in turn will result in a lot of missed adverse events, and a higher percentage of false negative values.
A Systematic Review of Methods of Fixation of Greater Trochanter Fracture during Hip Arthroplasty
Authors: Farag Osama , Mehasseb Ahmed , Mohamed Islam , Taalb Ahmed 
Published: July 2024

Abstract

Background
The rigid fixation of greater trochanter has been supported by more and more surgeons, but the choice of fixation is still controversial. Traditional steel wires and titanium is widely used because of its relatively simple procedure and low cost. But the high failure rate of internal fixation also led orthopedists to seek for other more effective fixation methods.

Objective
To compare between methods of fixation of greater trochanter during hip arthroplasty according to type and postoperative outcome.

Patients and Methods
Studies that meet the inclusion criteria were reviewed and data were analysed. We assessed the participants, methods, and intervention effects of included studies for heterogeneity. This enabled us to determine whether results can be pooled across studies.

Results
This review was on Non randomized and randomized controlled trials, prospective and retrospective studies which compare different methods of fixation of trochanter during hip arthroplasty. The search strategy identified 780 unique citations. Screening of titles and Abstracts identified 93 potentially relevant articles. Full text review of these articles identified 10 studies meeting the inclusion criteria. 10 studies were included 8 were retrospective and 2 prospective studies.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021.

Data Extraction
If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion
The different fixation methods were successful in achieving proper reduction and fixation of greater trochanteric fractures during hip arthroplasty. We preferred the cable plates, which not only provides strongest fixation but also results in lower rate of postoperative complications. But further prospective randomized and cohort studies are needed to validate their safety and efficacy.
Functional Outcomes of Primary Subtalar Arthrodesis versus Late Subtalar Arthrodesis in Sanders Type IV Calcaneal Fractures
Authors: Naguib Bishoy Emil , ElShazly Ossama Abdelraouf , Abd-Ella Mohamed Mokhtar , Abdelrahman Amr Farouk 
Published: July 2024

Abstract

Background
Sanders type IV calcaneal fractures are challenging. They are more likely to result in painful subtalar arthritis and subsequent subtalar arthrodesis. There is no consensus about the best management, so our study was conducted to compare the functional outcomes of primary subtalar arthrodesis with those of late subtalar arthrodesis.

Methods
From 2019 till 2022, 34 patients with Sanders type IV calcaneal fractures were included. Seventeen patients were managed by open reduction and internal fixation plus primary subtalar arthrodesis, while the other seventeen patients were treated conservatively followed by calcaneoplasty and late subtalar arthrodesis. Outcomes were measured by two scores: (1) the American Orthopaedic Foot and Ankle Society’s Ankle-Hindfoot scale (AOFAS-AHS) and (2)Foot and Ankle Ability Measure - Activities of Daily Living sub scale (FAAM-ADL). We also documented the union rate at one year, the wound complications and the need for second surgeries.

Results
Twenty-nine patients were followed for at least two years. At one-year follow up, the mean AOFAS-AHS for group A and group B were 72.86 (SD 3.13) and 70.80 (SD 3.63) (P = .12) respectively, while the mean FAAM score for group A and B were, respectively, 57.29/84 (68.20%) (SD 2.27) and 55.27/84 (65.80%) (SD 2.74) (P = .04). At two-year follow up, the mean AOFAS-AHS for group A and group B were 74.42 (SD 1.95) and 73.80 (SD 1.9) (P = .88) respectively, while the mean FAAM score for group A and B were, respectively, 59.21/84 (70.49%) (SD 1.6) and 58.73/84 (69.92%) (SD 1.7) (P = .44). The complications were comparable.

Conclusion
Primary subtalar arthrodesis is a successful treatment option for these severe life-changing fractures. It may reduce the overall disability time.

Level of Evidence
Level II