bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Standard Fine Needle Aspiration versus Fine Needle Biopsy for Endoscopic Ultrasound Guided Sampling of Solid Lesions
Authors: Sayed Moataz Mohammed , Aziz Ayman Mohammed Abdel , Ragab Khaled Mohammed Abdelaziz , Abdelnaby Kareem Ahmed Mahmoud , Ahmed Shaimaa Youssef 
Published: August 2023

Abstract

Background
Endoscopic ultrasound (EUS) -guided tissue acquisition is the standard of care for the diagnosis of solid pancreatic lesions. Traditionally, sampling is performed through fine-needle aspiration and the diagnosis is made through cytology. The challenge in solid pancreatic lesions is that they are often fibrotic, with significant necrosis limiting the cellularity of samples obtained via fine-needle aspiration.

Aim of the Work
The aim of the current study was to compare fine needle aspiration versus fineneedle biopsy for the diagnostic yield of malignancy. - The secondary objectives are to compare fine needle aspiration versus fine-needle biopsy for: 1) The overall diagnostic yield from solid lesions. 2) The diagnostic yield from pancreatic and nonpancreatic solid lesions. 3) The crossover diagnostic yield. 4) The sample quality obtained by either the slow-pull or suction approaches, respectively.

Patients and Methods
This is a cross-sectional study, included 92 patients (52 male and 40 female), age ranges from (18-80 y); with indeterminate pancreatic lesions and gastric lesions selected randomly from April 2021 till March 2022 from the outpatient clinics of Theodor Bilharz Research Institute.

Results
The most common lesion founded in fine needle aspiration group by CT or MRI was Pancreatic soft tissue mass in 86.9% and in the fine needle Biopsy group was also Pancreatic soft tissue mass in 80.4% with a statistically difference in between. The most common lesion founded in FNA group by EUS was Pancreatic soft tissue mass in 73.9% and in the FNB group was also Pancreatic soft tissue mass in 89.1% with a statistically difference in between. The cytologic examination shows 60.8% of FNA group and 69.5% of FNB group are malignant lesions. the majority of the lesions were Pancreatic adenocarcinoma in the FNA group was 47.8% and in FNB group was 56.5%. The sensitivity was 97.8% versus 92.5%, specificity 96.4% versus 92.8%, PPV 95% versus 90%, NPV 100% versus 96%, and accuracy 97.2% versus 92.7% for FNA and FNB, respectively

Conclusion
EUS-FNA is superior to EUS-FNB in sampling pancreatic masses. EUS-guided FNA and FNB are safe, appropriate procedures that have comparable diagnostic accuracy for solid lesions within the gastrointestinal tract. The 22-G FNB needles are easy handling in anatomically challenging locations and required fewer needle passes to reach diagnosis.
Effect of Fasting Ramadan on Different Laboratory Parameters on Type 2 Diabetic Mellitus Patients
Authors: Amer Hanan Mohamed , Eid Yara Mohamed , Mahdy Maram Mohamed Maher , Kabany Yomna Neamt Allah A L 
Published: August 2023

Background
Diabetes mellitus (DM) is one of the most common chronic diseases in nearly all countries, and continues to increase in numbers and significance, as changing lifestyles lead to reduced physical activity, and increased obesity. It has been estimated that by the year 2030, there will be 8.6 million adult with diabetes in Egypt, making it the country with the tenth largest population of diabetic in the world. Diabetes is associated with reduced life expectancy, significant morbidity due to micro and macro vascular complications and diminished quality of life.

Objective
To study the impact of Ramadan fasting on metabolic parameters and anthropometry in type 2 DM in Egypt.

Patients and Methods
This study was conducted on 80 type 2 diabetic patients who were intending to fast Ramadan. During Ramadan (2014) the average fasting hours were 15 h. Patients were recruited from the internal medicine outpatient clinic at Ain Shams University hospitals and from the nutrition institute. 6 Patients were under insulin treatment (Biphasic human insulin) & 74 patients were under oral hypoglycemic treatment {52 on combination treatment sulfonylurea + metformin & 9 on metformin only &13 of them were on sulfonylurea only}.

Results
We found that there was a statistically significant increase as regard lipid profile (serum triglycerides, serum total cholesterol, LDL-cholesterol and HDL-cholesterol) in after Ramadan measurement. Also CVD risk parameters have untimely increased after Ramadan this parameters including (10 years risk (Framingham score) systolic and diastolic blood pressure). In addition (Creatinine, HOMA IR and fasting insulin) showed increased level in after Ramadan measurement which indicate deterioration of blood glucose parameters. There was no statistical significant changes seen as regard anthropometric measures (BMI, WHR) in pre Ramadan and after Ramadan measurement. Also there was no statistical significant changes regarding fasting, 2 hours plasma glucose, A1c levels between pre-Ramadan fasting & after-Ramadan. In addition CRP and ACR showed no significant changes as regard measurement between before and after Ramadan.

Conclusion
Ramadan fasting appears to have significant effect on lipid profiles that could adversely impact cardiovascular outcome. These effects are mostly due to quality and quantity of food intake during Ramadan and the negative impact of sedentary life style. In addition the number of fasting days and period of daily fasting could affect glycemic control and renal function tests. Bad dietary habits, lack of exercise and irregular drug intake during Ramadan has a negative impact on glycemic control.
Radiological Assessment of Aphasia Outcome: A Case Report
Authors: Alloush Taha Kamel Taha , Emara Tamer Hussein Fahmy , El-Sudany Ayman Hassan Othman , Mahmoud Mostafa Khalf Ramadan 
Published: August 2023

Background
Stroke is a leading cause of major adult disability, and aphasia is one of the most common consequences of stroke. It has been reported that 21%–38% of patients with stroke have aphasia in the acute stage.

Case presentation
A 64- year old Egyptian male diagnosed with recent ischemic stroke in the form of the form of inability to express himself in spoken words; Broca’s aphasia. Diffusion tensor tractography (DTT) was done to assess the integrity of the arcuate fasciculus in the acute stage as a method to predict the possible outcome of the patient aphasia. DTT showed affection of broca’s territory of the arcuate fasciculus (AF) and it could be reconstructed measured by fractionated anisotropy (0.469). The patient initial aphasia test measured (47). Three months later, the patient improved and follow up aphasia test measured (74.4).

Results
Reconstruction of the arcuate fasciculus by DTT in the early stage of aphasia as shown in our patient carries a good clinical prognosis. Our patient aphasia improved markedly at 3 months follow up visit.

Conclusion
DTT could be a helpful tool to assess the outcome of aphasia at the early stage of acute ischemic stroke.
Comparison between the Effects of Ultrasound Guided Local Insulin Injections versus Hydrodissection of Normal Saline in Carpal Tunnel Syndrome Patients with Diabetes Mellitus
Authors: Mohamed Muhyadin H , Al-sadek Ahmed M , Moustafa Ramez R , Mohamed Amr A 
Published: August 2023

Background
Hydrodissection is a minimally invasive procedure of injecting fluid into anatomic spaces to facilitate dissection and adhesiolysis in peripheral nerve entrapments. The near-nerve local insulin injection is thought to promote neuronal growth and regeneration, and could be important in restoring nerve function following metabolic or vascular damage.

Aim of the Work
to compare the short-term effects of insulin and normal saline local injections in the treatment of patients with diabetes mellitus who have mild-to-moderate carpal tunnel syndrome.

Patients and Methods
A comparative study was conducted on 30 carpal tunnel syndrome patients with diabetes mellitus during recruited from Ain Shams University Hospital, Neurosonology, neurology department during the period January 2020 to March 2021 according to the regulation of Ain Shams University ethical and scientific committee. The privacy of participants and confidentiality of the data were guaranteed during various phases of the study.

Results
the Hydrodissection (10 ml of normal saline) of the median nerve is significantly effective in the treatment of mild to moderate carpal tunnel syndrome in patients with diabetes mellitus and alleviates the symptoms of CTS. Also the study showed that the local insulin injection (10 IU of NPH) alone is significantly effective in the management of mild to moderate carpal tunnel syndrome of diabetic patients, which shows significant response within two weeks of follow up. The study shows that Hydrodissection is slightly superior to insulin for treatment of CTS. Furthermore our current study compares the failure rate of both treatment modalities which implies that Hydrodissection group are less failure rate than insulin group, but this difference is insignificant due small sample size of both groups.

Conclusion
Hydrodissection and local insulin injection are effective methods in the management of mild to moderate Carpal Tunnel Syndrome of diabetic patients with superiority of ultrasound guided hydrodissection to Insulin. It is noteworthy this study is considered a pioneer in comparing HD and Insulin in managing CTS.
Post Stroke Epilepsy: The Prevalence and Predictive Factors among Egyptian Adults
Authors: ELNahas Nevine , Shokri Hossam , Fathy Mai , Allam Osama 
Published: August 2023

Introduction
In Egypt, few epidemiologic reports have highlighted the burden of PSE although cerebrovascular strokes are the 3rd most common cause of death among Egyptians. In this study we aim to investigate the prevalence of PSE among Egyptian adults.

Materials and Methods
Patients who presented with strokes at ASU and ASUSH stroke centers from January 2016 till December 2019 were interviewed through phone call questionnaire and were asked about occurrence of PSE.

Result
Among the study population 450(64.3%) patients were hypertensive, 322(46%) patients were diabetic, 128(18.3%) patients had significant carotid stenosis,127(18.2%) were smokers,94(13.4%) were dyslipidemic, 83(11.9%) patients had atrial fibrillation

Conclusion
HTN and DM are the most common risk factors among patients with PSE.
Endoscopic Endonasal versus Conventional MicroscopicTranscranial Approach in Management of Patients with Supra-Sellar Meningiomas
Authors: Ghobashy Mohamed Ashraf , Elsayed Desouky Ahmed , Elgayar Abdel Rahman Hesham , Arakeep Ashraf Mohamed 
Published: August 2023

Background
Meningiomas located at the anterior skull base are amenable to surgical resection. tuberculum sellae meningioma (TSM) originate in the sellar region, and similarly, account for approximately 5–10% of all intracranial meningioma. Although slow-growing, these tumors through mass effect upon, the optic nerve, pituitary gland and carotid arteries, can present symptomatically. The intention of surgery is to alleviate these symptoms without incurring neurological deficit.

Objective
To review and summarize available knowledge on the comparison between Endoscopic Endonasal versus conventional Microscopic Transcranial approach in Management of patients with supra-sellar Meningiomas with regard to clinical outcome and extent of tumor excision and complications.

Materials and Methods
This Systematic review/Meta-analysis included 10 studies from 2007 to 2019, all were retrospective studies summarize available knowledge on the comparison between Endoscopic Endo-nasal versus conventional Microscopic Trans-cranial approach in Management of patients with supra-sellar Meningiomas with regard to clinical outcome and extent of tumor excision and complications.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal).

Results
Gross total resection (mean, 95% CI: 1.12,2.66) Z = 2.47, (p0.01). Visual improvement (mean, 95% CI: 1.72,7.33) Z = 3.42, (p0.0006). CSF leakage (mean, 95% CI: 1.87,10.39) Z = 3.39, (p0.0007) Near total resection (mean, 95% CI: 0.28,1.0) Z = 1.95, (p0.05). Overall Complications (mean, 95% CI: 0.80,4.58) Z = 1.45, (p0.15). Recurrence (mean, 95% CI: 0.64,2.71) Z = 0.78, (p0.45). Mortality (mean, 95% CI: 0.34,5.78) Z = 0.46, (p0.64).

Conclusion
Supra Sellar Meningiomas is amenable to surgical resection. This can be performed by the traditional Trans-cranial Approach, or the Endoscopic Endo-nasal Approach with largely comparable operative outcomes. However, this meta-analysis demonstrated through direct comparative studies, that differences in postoperative complications do exist, where the Endoscopic Endo-nasal Approach is associated with lower likelihood of worse vision, and higher CSF leak, the Endoscopic Endo-nasal Approach was significantly better than trans-cranial approach as regard gross total resection. There was insignificant differences between two procedure in recurrence and mortality. Neurosurgeons caring for patients with these supra-sellar meningiomas should be prepared to offer an appropriate approach based on current available evidence involving the specific meningioma type.
Surgical Management of Sphenoid Wing Meningioma
Authors: El-Bahy Khaled M , Kabil Mohamed S , Ahmed Omar E , Hassan Hamdy T 
Published: August 2023

Background
Sphenoid ridge meningiomas constitute about 11.9% of all intracranial meningiomas. In 1938, they were classified by Cushing and Eisenhardt into outer (pterional), middle (alar), and inner (deep, clinoidal) lesions. Despite technical advances in neuroimaging and microsurgical techniques, large meningiomas arising from the sphenoid wing still a surgical challenge.

Patients and Methods
Between May 2015 and October 2019, 40 patients with meningiomas primarily originating from sphenoid ridge were planned for surgical management either with total excision or subtotal +GKS or for GKS from the start,9 cases were lateral, 11 were meddle,14 were medial and 6 enplaque and we can summarize that in lateral and middle meningioma total excision is the main role in treatment as long as vascular structures are secured, while GKS playing essential role in medial group, small conviened lesions less than 3 cmm in maximum diameter could be treated directly with GKS, larger lesions subtotal excision as safe as possible is 1st step followed by GKS for residual, meningioma en plaque carry high incidence of recurrence as total excision is difficult and GKS could not treating hyperostotic bone.

Results
GKS plays a very essential role in treating medial sphenoid meningiomas (63.6%) while surgical incision is the golden standard management of other types of meningiomas (88.8%) in lateral and middle groups and (50%) in meningioma enplaque.

Conclusions
The surgical treatment of sphenoid wing meningiomas still represents a challenge for neurosurgeons. Surgery for sphenoid wing meningiomas poses a variety of problems reflecting the complex anatomy of the sphenoid region. The surgical decision for these tumors should depend primarily on clinical finding of the patient and radiological finding of the tumor. Location of the meningioma is an important factor determining the degree of tumor resectability. Encasement of MCA and their branches and extension into superior orbital fissure and cavernous sinus are limiting factors for radical removal.
Predictors of the Need for Cerebrospinal Fluid Diversion in Patients with Myelomeningocele
Authors: Abdelfatah Mohamed A R , Mamdouh Ibrahim Michael , Elsayed Abdelbar Ahmed , Khalil Hamdy Ibrahim , Elsayed Ali Nosseir Mohamed 
Published: August 2023

Background
There is no consensus about the optimal timing and the criteria for cerebrospinal fluid diversion in children with myelomeningocele (MM). The aim of this work is to assess the predictors of the need for cerebrospinal fluid diversion in patients with myelomeningocele to avoid the unnecessary shunting with its complications.

Patients and Methods
This prospective study included fifty infants with myelomeningocele that were managed in the Neurosurgical department in Ain shams University hospital and October health insurance hospital from August 2016 till December 2018.

Results
In this study, 22 (44%) patients needed a shunt surgery after repair of the myelomeningocele. The age at presentation was highly significant (HS) for the need for shunt (P-value 0.006), with median age of 4.25 months. There were 22 cases (44%) that crossed the head circumference percentile for age while 28 cases (56%) matched; This was statistically highly significant (P-value 0.000). All patients with lax anterior fontanel (AF) or with mild bulge didn’t need a shunt, while all patients with tense AF needed a shunt (P-value 0.000). It was noticed that persistent vomiting was a sensitive indicator of the increased intracranial pressure since it occurred in all the cases who required shunt, this was statistically highly significant (P-vale 0.000). Four cases (8% of the cases) suffered from cerebrospinal fluid leak from the myelomeningocele wound within the first week post MM repair.

Conclusion
AF status & HC percentile for age represent the most reliable clinical signs to identify those who will need & benefit from a CSF diversion. The VP shunt should be preserved for cases exhibiting progressive signs of increased ICP (moderate to severe AF bulge- HC crossing percentile for age), while cases showing ventriculomegaly on imaging without signs of increased ICP should be followed up.
Comparative Study in Recurrent Disc Surgery between Posterior Lumbar Fusion with Interbody Fusion versus Posterior Lumbar Fusion Alone
Authors: Ali Ali Kotb , Saoud Khaled Mohamed , Farghaly Ahmed Roshdy , Mohammed Mohamed Abdel Moaty 
Published: August 2023

Background
Although surgical treatment of lumbar disc herniation is successful in most patients, discectomy can lead to unsatisfactory outcomes, such as recurrent or increased and/or sciatic pain. Standard open discectomy is associated with a 5% to 20% failure rate
The main causes of this clinical entity, known as failed back surgery syndrome, include inadequate diagnosis, improper patient selection, inadequate surgical decompression (e.g. failure to recognize lateral recess stenosis, lateral disc herniation or sequestrated free fragments), recurrent disc herniation at the operated level or at another level, and epidural fibrosis. Recurrent herniation is one of the most common reasons for an unsatisfactory outcome and occurs in 5%–11% of surgically treated patients

Aim of the Work
is to evaluate and compare the results of recurrent disc surgery with transpedicular screw fixation alone and transpedicular screw fixation with interbody fusion using either in posterior lumbar interbody fusion (PLIF) or Transforaminal Lumbar Interbody Fusion (TLIF) techniques and outcome and complications of both techniques.

Patients and Methods
This study was 60 patients with recurrent lumbar disc herniation divided into two groups:

Group A
treated by a repeat discectomy with postero-lateral fusion and transpedicular screw insertion.

Group B
treated by a repeat discectomy with transpedicular screw insertion and interbody fusion either by (PLIF) or (TLIF).

Result
In Our study was conducted on 60 patients with first time recurrent lumbar disc herniation after exclusion of cases with disc herniation with other pathology such as (multi segmental spinal canal stenosis, adjacent level disc herniation, spondylolythesis, and spinal deformities). After a mean follow-up of 14.13 (±2.39 STD) months, in 30 patient undergo recurrent discectomy with pedicle screw fixation only, a mean follow-up of 10.50 (±1.81STD) months, in 30 patient undergo recurrent discectomy with pedicle screw fixation with interbody fusion. Considering these data, we can note that both pedicle screw fixation alone comparing it with in pedicle screw fixation with inter body fusion have comparable results when used with revision discectomy but PLF has significantly less total cost than PLF+Interbody fusion.
However, the complication occurs in pedicle screw fixation with inter body fusion is more than that occur in pedicle screw fixation alone, more time consuming in the theater and more total prosthetic cost.

Conclusion
repeat discectomy with posterolateral fusion and interbody fusion for true recurrent lumbar disc herniation with evident recurrent sciatica and low back pain is more effective than discectomy with posterolateral fusion alone.

Abbreviations
PLIF: posterior lumbar interbody fusion; TLIF: Transforaminal Lumbar Interbody Fusion
Efficacy of the Non-Surgical Treatment of Chronic Subdural Hematoma: A Systematic Review
Authors: Abdallah El Wardany Mohammed , AbdelFatah Mohamed Abdel Rahman , Ismaiel Ibrahim Abdelmohsen Abdelnaiem , El Shawady Sherif Bahaa Eldin Abdel Mohsen 
Published: August 2023

Background
Chronic subdural hematoma (CSDH) is one of the most common neurological diseases. Surgical treatment is the gold standard treatment. However, the hematoma recurs in up to 25% of cases. In addition, many complications may occur after surgery. Despite the fact that conservative treatment for CSDH has grown in popularity, no medicine currently has level 1 evidence to back it up.

Objective
To figure out the efficacy of the non-surgical treatment of CSDH and to highlight its role in mildly symptomatic or asymptomatic patients.

Patients and Methods
The following electronic databases were searched for studies from 2000 to 2020: PubMed, Google Scholar, EMBASE, and Science Direct, using appropriate combinations of the following Keywords: chronic subdural hematoma, hemorrhage, CSDH, bleeding, non-surgical treatment, conservative management or treatment, alternative management or treatment, dexamethasone, steroids, corticosteroid, pharmacological treatment.

Results
Fifteen studies met our selection criteria. A total of 616 patients received medical treatment for CSDH. Their mean age was 70.49 years, including 468 males (76%) and 148 females (24%). Improvement of the presenting symptoms occurred in 477 patients (77.44%), and 139 patients (22.56%) required surgical intervention.

Conclusion
The results of the previous studies suggested that medical treatment in selected patients was a valid option as a primary treatment and as an adjuvant therapy with surgical evacuation for CSDH. Further randomized controlled studies with larger patient cohorts are needed to determine the true value of each drug in the conservative treatment of CSDH.