bluuebunny/crossref_metadata_2025_split huggingface dataset:
Propranolol and Misoprostol versus Misoprostol Alone for Induction of Labour in Primigravidas
Authors: Elzeneiny Hazem Amin Hassan , el-Hamid Ahmed Sherif Abd , Nawara Maii Medhat , Ismael Ahmed Mohamed Fathy 
Published: August 2023

Background
Induction of labor is indicated when risks to maternal or fetal health out weight benefits of continuing the pregnancy. One of the most common reasons for labor induction is postterm pregnancy (ie,&gt; 41 weeks of gestation).

Objectives
The aim of the study is to compare propranolol and misoprostol versus misoprostol alone for induction of labour in primigravidas.

Patients and Methods
This study included one hundred and twenty eight pregnant fullterm primigravida women, they were divided randomly into two equal groups. In both group, every patient received 25 microgram of misoprostol vaginally under aseptic prequations then every 6 hours with maximum 4 doses until efficient uterine contractions is reached three or more in 10 minutes each lasting for 45 seconds for induction of labor. Then after 30 minutes patients in group A received oral propranolol 20 mg and patients in group B received oral placebo in the form of sugary tablets, then womens monitored for fetal and maternal wellbeing and progress of labor.

Results
In this study, all the parturients were primigravid, it was highly considered to recruit parturient of almost similar conditions. The mean age of women included in the study was (23.3+/4.1) and the mean gestational age of the parturient was range (38 – 42) weeks. The mean pre induction Bishop score was range (2-6), we select only women with Bishop score of 6 or less considering the fact that the main goal for using medication for induction of labor was the reppening of an unfaverable cervix. There was no statistical difference between both groups as regards initial basic characteristics. There was no statically significant difference between propranolol and placebo research group regarding birth weight, apgar score at 1 and 5 minutes and NICU administration and patients satisfaction.

Conclusion
From the previous results regarding the propranolol effectiveness and safety, it dose not seem to negatively influence the fetus as apgar score at 1 and 5 minutes and the need for NICU admission were not influenced by its administration. And on the other hand, propranolol was significant in reduction the time latent phase and therefore the total duration of labor. Taking in mind this significant results it seems that propranolol might become a useful obestetrical tool for induction of labor in the future.
Oxytocin Infusion versus Vaginal Misoprostol in Reducing Blood Loss during Abdominal Myomectomy: A Randomized Controlled Trial
Authors: AbdElGawaad Magdy Mohamed Mahmoud , El Husseiny Salama Ahmed , Salama Mohammed Hamed , Elfar Marwan Hassan Alsaid 
Published: August 2023

Background
Uterine myomas are most prevalent benign tumors in reproductive-aged women. Myomectomy is an alternative to hysterectomy for women who wish to retain their uterus but it is associated with higher risk of blood loss, greater operative time and need for blood transfusion. Knowledge of the effectiveness of the interventions to reduce bleeding during myomectomy is essential to enable evidence-based clinical decisions.

Aim of the Work
The aim of the study is to compare between the efficacy of intraoperative oxytocin infusion and preoperative vaginal misoprostol in reducing blood loss during abdominal myomectomies.

Methods
In a prospective randomized controlled trial which was conducted at Ain shams maternity Hospital in Cairo from July 2017 to May 2021.100 women who had abdominal myomectomy for symptomatic leiomyomas were enrolled. Patients were randomly assigned to 2 groups. Group O (Oxytocin group) patients (n = 50) received 30 U oxytocin in 500 ml normal saline infusion intraoperative and Group M (Misoprostol group) An hour before the operation, patients (n = 50) received a single dose of vaginal misoprostol (400 μg). The primary outcome was the operative blood loss. The secondary outcomes were the need for blood transfusion, change in hemoglobin (Hb) and hematocrit (Hct) levels 24 h after operation, conversion to hysterectomy, hospitalization and the prevalence of side effects.

Results
Intra-operative blood loss was significantly lower in those women randomized to receive vaginal misoprostol versus the oxytocin infusion group (458.5 ± 115.4 mL vs 618.8 ± 115.1 ml {P = &lt; 0.001}). Misoprostol group showed lower mean blood loss by – 160.3 ml (95% CI -206.0 to -114.6) and reduced need for blood transfusion (RR 0.22, 95% CI 0.005 to 0.98) {P = 0.025}. Additionally, there was a highly significant statistical difference between Misoprostol group and Oxytocin group as regards the postoperative hemoglobin, hematocrit concentration, operative time as Misoprostol group showed a higher postoperative hemoglobin and hematocrit concentration, and less operative time. There was no difference in the patient demographics, intraoperative characteristics, postoperative stay, complications, and the side effects between the two groups.

Conclusion
As evident from the current study, pre-operative misoprostol in abdominal myomectomy is a safe and reliable method that offers some practical advantages, such as reducing intra-operative blood loss and blood transfusion needs
Evaluation of Endothelial Cell Density after Torsional Phaco-Emulsification in Patients with Pseudo-Exfoliation
Authors: Said Gaafar Ayman Abd El Moneim Al , Youssef Mohamed Omar , Fayez Aziz Bassem , Rahman Ali Mohamed Ali Abd El 
Published: August 2023

Background
The corneal endothelium is a single layer of hexagonal cells that do not have the ability to regenerate. The normal density of corneal endothelial cells in adults is approximately 2500 cells/mm² and it is reduced by about 0.6% a year. The endothelium performs an essential function of maintaining the hydration of the cornea. When the endothelial cells density is reduced to approximately 800cells/mm², it may lead to corneal decompensation causing corneal edema and loss of corneal transparency which disrupts vision.

Aim of the Work
The aim of this study is to compare pre-operative corneal thickness between normal subjects and subjects with pseudo-exfoliation and to determine the effects of phaco-emulsification surgery on corneal endothelial cell density in cataract patients with pseudo-exfoliation syndrome.

Patients and Methods
The type of study was case controlled study, at department of Ophthalmology at Ain Shams University hospitals. This study included 66 patients divided to two equal groups (33 each): study group: 33 patients with pseudo-exfoliation, control group: 33 patients with senile cataract without pseudo-exfoliation.

Results
We found that ECD loss was 11.42% in the study group and 8.11% in the Control group 4 weeks after surgery. Phaco time and used BSS values were significantly higher in patients with PXS but had no significant influence on endothelial cell loss. They also suggested that the corneal endothelium in PXS be vulnerable to cataract surgery.

Conclusion
Torsional mode phacoemulsification and IOL implantation provided a safe and favorable surgical outcome in patients with/without PXS. Torsional phacoemulsification led to significantly higher ECD loss in the PXS than that in the control group during the whole follow up period.
Quality of Vision and Ocular Higher Order Aberrations after SMILE for Myopia and Myopic Astigmatism
Authors: Assaf Ahmed Samir , Youssef Mohamed Omar , Elrahman Sameh Hany Abd , Youssef Madonna Mimi Samaan 
Published: August 2023

Background
Previous studies have shown considerable amounts of higher order aberrations following SMILE. In our study we aim at accurately quantifying the higher order aberrations following SMILE in myopia and myopic astigmatism.

Objective
To detect the effect of SMILE on quality of vision and the incidence of higher order aberrations following SMILE.

Patients and Methods
This is a prospective study that included 30 eyes of 18 patients presented in the outpatient clinic seeking advice for myopic refractive surgical correction. The study was conducted in accordance with the ethical standards stated by the ethical committee of Ain shams university hospitals with informed consents obtained from all participants.

Results
On studying the post-operative corneal third order aberrations we detected increase in post-operative vertical and horizontal coma, and spherical aberrations with non-significant change in vertical and horizontal trefoil. According to our study results, SMILE is an effective refractive surgery that improves visual acuity. That causes decrease in quality of vision through modulation transfer ratio and increase in ocular higher order aberrations.

Conclusion
SMILE (small incision lenticule extraction) is an efficient modality for refractive surgical correction of myopia and myopic astigmatism, with significant post-operative improvement in unaided visual acuity detected post-operative increase in the ocular HOAs. Total coma, trefoil and sphere increase significantly in mesopic more than photopic pupil. The degree of myopia didn’t affect the ocular higher order aberrations except for modulation transfer ratio.
Assessment of Macular Function by Multifocal Electroretinography Following Idiopathic Epiretinal Membrane Surgery with Internal Limiting Membrane Peeling
Authors: Fathy Nada , Habib Ahmed , Magdy Karim , Embabi Sherif 
Published: August 2023

Purpose
To evaluate macular function before and after vitrectomy for idiopathic epiretinal membrane (ERM) with internal limiting membrane (ILM) peeling by multifocal electroretinography (mfERG) and their correlations with visual acuity (VA) and central subfoveal thickness (CST) by optical coherence tomography (OCT).

Settings and Design
A prospective interventional case series of 15 eyes with idiopathic ERM of 14 patients who underwent pars plana vitrectomy (PPV) for ERM removal with ILM peeling.

Methods
Multifocal electroretinography (mfERG) and OCT were performed preoperatively and one month after surgery. The response amplitude densities and implicit times of mfERG were analyzed. Correlation analyses among visual acuity, CST and mfERG values in the five concentric rings were performed.

Results
The first order responses of mfERG recorded preoperatively showed diffuse reduction in P1 amplitudes in all 5 rings with no statistically significant differences in mfERG responses after ERM surgery. Correlation coefficients showed a significant correlation between postoperative VA and P1 amplitude of ring 2 (P = 0.005). There was no significant correlation between postoperative CST and P1 amplitude for all rings

Conclusions
The mfERG responses in eyes with idiopathic ERM show macular function abnormalities and correlate with VA after surgery. The residual retinal distortion along with the damage to inner retinal layers and Muller cell dysfunction associated with ILM peeling affect the mfERG responses after surgery. The incorporation of mfERG into the pre- and post-operative assessment of patients with iERM, allow for identification of functional impairment and predict visual outcomes.
Triple Innominate Osteotomy in Management of Residual Acetabular Dysplasia in Young Adolescent Patients (Systematic Review and Meta-Analysis)
Authors: Mousa Thusly Mohamed , Aly Ahmad Saeed , Refaat Andrew Osama 
Published: August 2023

Background: Aim of the Work
The aim of this work is to provide cumulative data about the effic cy and safety of triple innominate osteotomy in management of residual acetabular dysplasia in young adolescent patients.

Methods
This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses

Results
We found that; the total number of patients in all the included studies was 631 patients; while their average follow up time was (7.2 ± 4.6 years); with longest follow up time of 14.5 years. The average age of all patients was (12.67 ± 3.7 years); with youngest mean age of 7.5 years. Regarding Pre-operative assessment, the average CE angle was (10.4 ± 7.2) degrees, and the average HHS score was (77.7 ± 17.69) degrees.
Regarding Post-operative sequel, the overall complications rate was (184/631) (29.1%), and the overall AVN rate was (123/631) (19.5%). Regarding 1 ry efficacy outcome measures,

Conclusion
Acetabular dysplasia is among the anatomical abnormalities seen in developmental dyplasia of the hip (DDH). One of the goals of surgical treatment during childhood is to achieve optimal femoral head coverage by correcting this architectural flaw, thereby preventing osteoarthritis. Pelvic osteotomy is a treatment option in children and adolescents with residual acetabular dysplasia after developmental dyplasia of the hip.
Systematic Review for Evaluation of Ilizarov External Fixator in Treatment of Open Fracture of Tibial Shaft
Authors: Fayed Mahmoud Mohamed H , Al-kersh Mohamed Ahmed , Elhalim Mohamed Adel Abd 
Published: August 2023

Background
Tibial shaft fractures are one of the most common long bone fractures. Open fracture tibial shaft is common between those fracture. The Ilizarov external fixator (IEF) is a minimally invasive method that permits effective wound management, early weight-bearing, and bone lengthening.

Aim of the Work
We aim to systematically review the Ilizarov external fixator in the treatment of open fracture of the tibial shaft.

Material and Methods
Regarding the methodology of our study, we followed the PRISMA statement guidelines during this study preparation and performed all steps according to the Cochrane handbook of systematic reviews of intervention. We searched PubMed, Scopus, Cochrane, and Web of Science, Embase, and Science Direct in June 2021 and updated the search in July 2021 using relevant Keywords.

Results
We found a significant difference regarding the outcome of operation time. IEF consumed more time than the other different approaches. The analysis favored IEF over other different approach regarding the overall postoperative excellent to good improvement. No significant different was found between both IEF and other approaches regarding the union time (per months) as well as the risk of reoperation. The postoperative superficial infection was the at the same risk between IEF and other different approaches, However, there is no significant difference regarding risk in postoperative deep infection after IEF. The overall postoperative infection rate was increased after IEF. No significant difference was found regarding the risk of either non-union or malunion rate, postoperative healing, and deep venous thrombosis (DVT).

Conclusion
We concluded that the IEF can be considered reliable alternative techniques over other techniques. The analysis demonstrated that it is possible to successfully treat diaphyseal tibial fractures using the Ilizarov method, a minimally invasive technique allowing immediate weight-bearing.
Endoscopic Rhizotomy in Management of Facetogenic Chronic Lumbar Pain
Authors: Askalany Sherine Yousery Gamal , Youssef Magdy Gamal Abdelkader , Fahmy Fady Michelle 
Published: August 2023

Background
Facet Arthritis causing Chronic Low Back Pain (CLBP) is an increasingly controversial field. The diagnosis of Facetogenic pain is still deemed difficult by many physicians, and its pathophysiology, as well as its management are still not quite understood. From the available literature, we can conclude that Lumbo-sacral Facet Arthritis is attributed to a degenerative process affecting the facet joint, which is described as the articulation between the superior articular process of one vertebrae and the inferior articular process of a vertebrae above. This degenerative process is commonly attributed to the „wear-and-tear' theory coming with age, highly comparative to the same degenerative process affecting any other joint.

Aim of the Work
to evaluate its effectiveness in controlling short term and long term pain caused by lumbar facet arthritis resulting in Chronic Low Back Pain (CLBP), and its effectiveness in decreasing disabilities caused by the debilitating symptoms of progressive arthritis in the lumbar facet joints.

Patients and Methods
was done to evaluate a novel technique, the Endoscopic Rhizotomy, as one of the minimally invasive procedures that is implemented in the management of Lumbar Facet Arthritis. All the available papers in literature describing this intervention from May 2000 to December 2020 were included.

Results
The initial search resulted in 468 articles from five databases including PubMed, Science Direct, Cochrane Library, Scopus, and Google Scholar. 16 studies are retrieved from additional databases. The total number before duplicates removal is 484 records.

Conclusion
that Endoscopic Rhizotomy is a very safe procedure, with a very low complication rate. We also concluded that Endoscopic Rhizotomy significantly relieves Facetogenic CLBP, with up to 3 years of pain relief. The procedure improved the subjective and objective quality of the patients. With comparison to the traditional Radiofrequency Ablation (RFA), Endoscopic Rhizotomy does not use radiation and allows direct visualization, in addition to being superior to RFA considering improving both pain and disability post-operative. It is considered a single day procedure, and the patient can return to work the 2nd day, fully-functioning. Without doubt, several factors, however, have to be taken into account when offering the patient such a procedure, as the presence of spinal deformities, instabilities, hypermobility, and the overall assessment of the patient‟s condition.
Factor VIII Level in the Potential Female Carrier Mothers of Patients with Hemophilia A and Its Impact on Joint Health
Authors: Tantawy Azza Abd El Gawad , Ragab Iman Ahmed , El-Sayed Saqr Hossam Moussa , El Din El Mekkawy Dalia Mohamed Ezz , El Kader Salwa Mostafa Abd , Elkyal Ahmed Ebrahim Ebrahim 
Published: August 2023

Background
Hemophilia A is an X-linked bleeding disorder. The characteristic bleeding phenotype in patients with severe hemophilia is recurrent spontaneous hemarthrosis with development of hemophilic arthropathy. Heterozygous female carriers with factor VIII (FVIII) activity level lower than 40% may be at risk for bleeding that is usually comparable to that seen in males with mild hemophilia.

Aim of the Work
To assess factor VIII level in mothers of known patients of hemophilia A correlating it with the frequency of clinically and radiologically documented arthropathy.

Patients and Methods
A cross sectional study included 40 mothers of patient with hemophilia A during the period from September 2020 to September 2021. Studied participants were subjected to detailed analysis of bleeding history, six major joints range of motion (ROM) examination, functional independence score in hemophilia (FISH), FVIII level one stage assessment and magnetic resonant imaging (MRI) of the reported affected joints.

Results
Mean age of mothers is 42.25 ± 7.74 years. Eleven mothers (27.5%) had no bleeding symptoms, 16 (40%) had one bleeding symptoms and 13 (32.5%) had two or more bleeding symptoms. As regard joint pain, 13 (32.5%) had severe pain, 3 (7.5%) had ankle pain and 2 (5%) had elbow pain with a mean pain score of 2.55±3.32, and 7 (17.5%) had bilateral pain. Mean FVIII activity was 43.33 IU (± 22.79), ranging from FVIII (0 &lt; 30 IU) in 13 (32.5%), FVIII (30 &lt;60) in 18 (45.0%) and FVIII ≥ 60 IU in 9 (22.5%) among the studied participants. Knees were the most affected joints with decreased mean ROM (±SD) in right and left knees of (123.25 (±12.06) and 120.00 (±15.81)) respectively. The median MRI scores were studied was 5 (2.6%) with median osteochondral changes of 4 (2.5%) and median soft tissue changes of 1 (0-1), their median FISH score of 8 (8-9). By comparing groups at the level of factor VIII, there was no significant difference according to anthropometric bleeding parameters, pain, and MRI score. None of participants needed hospital admission, factor VIII replacement or packed red cells replacement.

Conclusion
Potential female hemophilia A carriers are at risk of spontaneous bleeding which may entail bleeding in the joints, causing early joint damage. They showed reduced overall joint ROM and structural osteochondral changes in MRI joint examination which mandates further studies about early detection of potential female hemophilia carriers for the possible need of early medical intervention.
Predictors and Outcomes of Multidrug-Resistant Gram-Negative Bacterial Bloodstream Infections in Pediatric Oncology Patients
Authors: Hamdy El-Sayed Manal , Eltonbary Khadiga Yehia , Sayed Safa Matbouly , El-Salam Ahmed Yasser Abd 
Published: August 2023

Background
Pediatric patients with cancer are at great risk of infection either from disease process or after being immuno-suppressed by chemotherapy and radiotherapy, this is especially with gram negative and multidrug resistant (MDR) pathogens.
The primary aim of our study is to detect the frequency of multidrug resistant gram negative bacteria (MDR-GNB) infections at the Pediatric Oncology Department.
The secondary aim is to identify the patterns of resistance of different pathogens to commonly used antimicrobials and detect the risk factors and outcomes of MDR-GNB infections in pediatric oncology patients.

Patients and Methods
We studied episodes of fever and /or bacteremia in children (aged 1 m to 18 y) with hematologic and solid malignancies in the pediatric oncology department in Ain Shams University Hospital between January 2020 and March 2021. We studied different risks for MDR-GNB including sex, age, underlying malignancy, the presence of indwelling catheter, absolute neutrophil count and other laboratory investigations.

Results
MDR bacteria were isolated in about 15% samples. The most commonly detected MDR-GNB pathogens were Klebsiella (61.1%) and Acintobacter (22.2%). Among studied patients, MDR-GNB were significantly reported among patients with T-lymphoblastic lymphoma (p = 0.006). Although most patients were neutropenic, neutrophil count was not significantly correlated (p = 0.981). Low serum albumin on the other hand was significantly correlated with MDR-GNB (p = 0.009).

Conclusion
MDR-GNB is a significant threat to pediatric oncology patients. Contact precautions for all patients with colonization or infection with MDR pathogens and an antimicrobial stewardship based on local epidemiology should be implemented to prevent MDR infections.