bluuebunny/crossref_metadata_2025_split huggingface dataset:
Doppler Guided Haemorrhoidal Artery Ligation in the Management of Symptomatic Hemorrhoids
Authors: Abdel-Mageed Ahmed Alaa-Eldin , Abdel-Samea Yasser Mohammed , Boutros Ayman Magdy , Morshed Ibram Nady Nashed 
Published: August 2023

Abstract

Background
Hemorrhoid ligation with mucopexy is a simple, safe and cost-effective ambulatory treatment for the patients of symptomatic hemorrhoids. It can be performed on an outpatient or day care basis on grade 3 and 4 hemorrhoids to control bleeding and prolapsing hemorrhoids. Overall the results of hemorrhoid ligation and mucopexy were satisfactory with good control of patients complains.

Objective
To evaluate prospectively the outcome of Doppler-guided hemorrhoidal artery ligation in the management of symptomatic hemorrhoids.

Patients and Methods
Types of studies: A prospective study. Study setting: The study conducted in Ain Shams University Hospital (El Demerdash) under supervision of these supervisors. Study period: Six months.

Results
It is easy for the surgeon to learn it and acquire appropriate skills after a short learning curve. The HAL is a minimally invasive technique that is conceptually painless for patients since all maneuvers and sutures are endoanal and above the dentate line; this helps an early recovery and allows an ambulatory procedure. We must bear in mind that postoperative pain is often the most common concern for patients and professionals dealing with hemorrhoids. The results of HAL in this study show a very low postoperative pain rate (two patients_ lower than 7%); moreover, it is easily controlled with oral analgesia. One patient (3%) complained of retention of urine, which controlled easily.

Conclusion
Hemorrhoid ligation with mucopexy is a simple, safe and cost-effective ambulatory treatment for the patients of symptomatic hemorrhoids. It can be performed on an outpatient or day care basis on all grades of hemorrhoids to control bleeding and prolapsing hemorrhoids. Overall the results of hemorrhoid ligation and mucopexy were satisfactory with good control of patients complains.
Predictive Factors of Lymph Nodes Recurrence in Patients with Differentiated Thyroid Carcinoma Post Thyroidectomy in Clinically Node Negative Patients: A Systematic Review and Meta-Analysis Study
Authors: El-Shafaei Mahmoud Ahmed Mohamed , Omran Hesham Mohamed Ali , Saad Ahmed Saeed , Mansi Lamiaa Gomaa Abdel Hafez 
Published: August 2023

Abstract

Background
Differentiated thyroid cancer (DTC), a term used to describe papillary thyroid cancer (PTC), follicular thyroid cancer (FTC), and Hürthle cell thyroid cancer (HTC), accounts for approximately 95% of all thyroid malignancies. The expression clinically lymph node-negative (cN0)‘ was used to describe the patients that did not show the clinical evidence of CLNM on US or other imaging modalities preoperatively.

Objective
To assess the incidence of recurrence after surgery for DTC and to identify predictive factors of recurrence.

Patients and Methods
The search was conducted through PubMed, Web of science, Scopes, and the Cochrane Library for data from inception to November 1, 2021 with a combination of the following terms: "clinically node negative", "Risk Factors" and "Thyroid Neoplasms". All the studies were reviewed according to the eligible criteria. Abstract-based eligibility studies were obtained, and the manuscripts were fully reviewed.

Results
There was no evidence of publication bias. The funnel plot analysis demonstrated a symmetrical appearance, and the P values were greater than 0.05 for all comparisons according to the Begg-Mazumdar test and eggers test.

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 meas ures.

Conclusion
Young age (&lt;45 years), male gender, Bilaterality, multifocality, capsular invasion, lymphovascular invasion and ETE were significantly associated with LNM in clinically N0 DTC patients and Prophylactic central neck dissection would be expected to have higher yield in patients with these factors.
Comparative Study of Reflux Esophagitis as a Complication between Mini-Gastric Bypass vs Sleeve Gastrectomy
Authors: Lashen Mohammed Ali , Helmy Elshayeb Bassem , Hellaly Mohammad Abdl Egani Muhammad 
Published: August 2023

Abstract

Background
All currently commonly performed bariatric operations involve manipulation and alteration of gastroesophageal anatomy, resulting in change of multiple physiologic parameters, such as gastric emptying and even the function of the lower esophageal sphincter (LES) itself. Reflux control involves a complex interplay of LES function, esophageal function, and gastric emptying. While all 3 can be affected by any foregut procedure, LES function and gastric emptying are most directly altered in bariatric surgery

Aim and Objectives
was for discussing the post-operative reflux esophagitis in both Mini gastric bypass & sleeve gastrectomy in the Treatment of Morbid Obesity.

Subjects and Methods
This prospective comparative study was carried out at ASU Hospital (El-Demerdash Hospital), Al Haram Hospital & other authorized hospitals between July 2017 and March 2019 and ethically approved. The study involved 40 Patients who were targeted to be recruited & randomly ordered to receive either Group 1 (MGBP (n = 20) or Group 2

Results
After 6 months of follow up, we found that reflux esophagitis symptoms remained postoperatively among patients who performed SG operation compared to the MGB group (15% vs 5%). This was statistically insignificant (p = 0.737). Although the resolve rate was higher in the SG group compared to the MGB group (15% vs 5%), this was statistically insignificant (p = 0.605).

Conclusion
LSG and LMGB are both safe and effective procedures for the surgical management of morbid obesity. Bleeding and leakage are the most common and most serious complications in both procedures. The incidence of complications between both procedures is not significantly different.
Rerouting as a Sphincter Saving Procedure for Management of Horseshoe Perianal Fistula
Authors: Abou-Zeid Ahmed Abdel Aziz , Ebied Essam Fakhery , Almoneim Mohammad Samir Abd 
Published: August 2023

Abstract

Background
Horseshoe fistula remains a complex and challenging clinical entity due to the configuration, depth, degree of sphincter involvement and confusing anatomy of the fistula. Lack of recognition, high rates of recurrence after insufficient treatment and incontinence are the dominant issues surrounding the management of the disease. We provide a new technique, which is staged fistulotomy with rerouting of transsphincteric track into intersphincteric position and the newly positioned intersphincteric fistula is then dealt with at a later date when the wound related to the external sphincter is soundly healed, so we achieve the gold standard lay open of the fistula in addition to minimal sphincter sacrificing aiming to the least recurrence rate and avoiding functional complications as much as possible.

Aim
The aim was to describe the surgical technique that we use for the treatment of horseshoe perianal fistula and to study its effect on recurrence and continence.

Patients and Methods
A prospective study in which thirty patients to be operated upon was recruited from Ain Shams University Hospital & Dar Elshefa Hospital. Staged fistulotomy with rerouting of transsphincteric track of the fistula into intersphincteric position was done. The newly positioned intersphincteric fistula is then dealt with at a later date when the wound related to the external sphincter is soundly healed.

Results
23 cases (76%) out of 30 cases to be operated upon underwent all stages of the procedure. As regard Patients underwent all stages of the procedure 20 cases (87%) developed no degree of incontinence 3 cases (13%) developed degree of incontinence (wexner score 2)(gas leak once a week). There were no cases of recurrence.

Conclusion
Staged fistulotomy for horseshoe fistula with rerouting of transsphincteric track into intersphincteric position was associated with no recurrence and accepted functional complications.
Evaluation of Central Quadrentectomy and Immediate Reconstruction in Patients with Retroareolar Breast Cancer
Authors: Kamel Amr , Zaid Karim Fahmy Abdel-Moaty Mohammed Hamdy , Hafez Omar Afifi 
Published: August 2023

Abstract

Background
Centrally located breast cancer represents 5–20 % of all breast cancer cases. Oncoplastic breast surgery combines oncological principles with plastic surgical techniques; it requires knowledge of anatomy, and appreciation of symmetry, esthetics and breast function.

Aim of the Work
The aim of the current study is to present and assess multiple techniques of surgical outcome of oncoplastic techniques following the resection of centrally located breast cancer.

Patients and Methods
This prospective study comprised of 24 female patients with central breast cancer from November 2018 to Feb 2020 at the department of surgery Ain-Shams University Hospitals. Patients were followed up every 3 months for at least 12 months. Informed consent was obtained from the patients, and this study was approved by Al.Demerdash Hospital ethics committee.

Results
In our study, statistics shows to some extent, When NAC is not involved Flierl and Hanker [11] reported satisfactory results with central quadrentectomy and immediate reconstruction in patients with retroareolar breast cancer.
The mean age was 49.83 ± 7.6 years (range; 39 to 60). 13/24 patients (54.16%) were premenopausal while 11/24 (45.83%) patients were postmenopausal. 5 patients had diabetes mellitus and the rest of patients were non diabetic. Four patients (16.6%) had positive family history of breast cancer. Six patients had nipple retraction (25%). The mean tumour size was 2.52 ± 0.64 cm cm (0.9-2.8 cm). The spectrum of safety margin ranged from (1.9-2.8 cm) the mean safety margin in our study is 2.19±0.32, The overall percentage of complications was 5/24 (20.8%). Pathological nipple infiltration was found in 12 cases (50%) showed clinical and/or radiological evidence of nipple involvement and underwent resection of the NAC (Grissoti and Melon slice techniques). 14 patients (58.33%) had positive axillary lymph nodes, all staged as pN1; while the other 10 patients (41.66%) where staged as pN0. There is significant statistical difference between the two groups; Patient dissatisfaction is due to presence of scar, breast shape asymmetry and absence of NAC as in Grisotti and Melon slice groups or asymmetry as in Inferior pedicle group.

Conclusion
Multiple oncoplastic breast surgery techniques used in treatment of CLBC with good cosmetic and oncological outcome but need more training to have good results.
The Effect of Nigella Sativa Oil on Imiquimod Induced Model of Psoriasis in Thin Skin of Adult Male Mice. A Histological Study
Authors: Fadel Hussieny Ayat , Kalleny Nagwa Kostandy , Mohammed Safaa Mohammed Shaker , EL-Waseef Dalia Alaa EL-Din Aly 
Published: August 2023

Abstract

Background
Psoriasis was reported to be a chronic, immune-mediated inflammatory skin disease. Psoriasis can be induced in mice by Imiquimod which is an immune response modifier and it is the most widely used animal model of psoriasis. Nigella sativa oil is frequently used for its antiinflammatory and anti-oxidant activities. The current study is aimed to assess the effect of oral Nigella Sativa oil on imiquimod induced model of psoriasis in thin skin of adult male mice.

Materials & methods
The current study included twenty male albino mice. After seven days acclimatization period, animals were subjected to shaving of square shaped area 2 x 2 cm2 at the backs of all mice. Then, animals were divided into three groups: Group I: Control, n = 10: subdivided into: Subgroup IA (Negative Control), Subgroup IB: which received a daily dose of 20 mg of Nigella sativa oil orally. Group II, n = 5: Each mouse received a daily topical dose of 62.5 mg IMQ cream on the shaved back skin for fourteen days. Group III, n = 5: Each mouse received a daily topical dose of 62.5 mg IMQ cream on the shaved back skin for fourteen days. On day seven after shaving and 4 hours after application of IMQ cream, each mouse in group III received 20 mg of Nigella sativa oil once daily for seven days. Skin specimens were obtained from the shaved parts of skin of the backs of all animals and were processed for light microscopic examination.

Results
Imiquimod (IMQ) application led to apparent increased epidermal thickness, apparent thickening of stratum corneum and alterations in the normal appearance of keratinocytes with vacuolation inside their cytoplasm and increased intracellular spaces between cells. Apparently Elongated epidermal rete ridges were observed along with abundant infiltrates of mononuclear inflammatory cells in the dermis. However, oral use of Nigella sativa oil (N.sativa) strongly inhibited IMQ-induced psoriasis-like inflammation and alleviated all epidermal and dermal changes observed after IMQ application.

Conclusion
N. sativa can be used as an effective treatment for modraete psoriasis.
G-EYE Colonoscopy Is Superior to Standard Colonoscopy for Increasing Adenoma/Polyp Detection Rate
Authors: Allam Ehab Hassan Nashaat , Aziz Ayman Mohamed Abdel , Elshafie Ahmed Ibrahim Mohamed , Mahmoud Karim Ahmed , Ahmed Abdallah Shehatah El-Sayed 
Published: August 2023

Abstract

Background
Colorectal cancer (CRC) is one of the most common cancers worldwide. Most CRCs develop from malignant potential polyps, especially adenomas, SSPs and SSLs. Screening is associated with a reduction in CRC incidence through the detection and removal of precancerous polyps and with reduction in CRC related death through reduction of the incidence and early detection of CRC. Colonoscopy is the most widely used screening tool. Unfortunately during colonoscopy examinations, a substantial number of polyps are still being missed. These missed polyps though to be at least 50% of interval CRCs.

Objective
comparison between G-EYE colonoscopy and standard colonoscopy (SC) for increasing adenoma/polyp detection rate.

Patients and Methods
prospective randomized study was conducted on 80 Patients as one group, selection done at Hepatology and Gastroenterology department in Theodor Bilharz Research Institute and Outpatient clinic of Gastroenterology unit at Ain Shams University Hospitals. From: June 2021 to November 2021, after ethical committee approval.

Results
prospective randomized study demonstrated that the polyp detection rate (PDR) was an increased rate by G-EYE colonoscopy, this difference was statistically significant (P ≤ 0.05) as the total number of patients having polyps detected by G-EYE was 28 (40.60%) and the total number of polyps was 43 polyps while by SC was 15 (21.70%) and the total number of polyps was 19 polyps. There is an advantage for G-EYE over SC in relation to the size of the detected polyps as this study compared the detected polyp size as diminutive (&lt;5 mm), small (6-9 mm) and large polyps (&gt;10 mm) by G-EYE versus SC. For the diminutive polyps, the difference was statistically significant (P ≤ 0.05) favoring the G-EYE, and for small polyps the G-EYE was superior to SC by 3 polyps, while for large polyps there was no difference. G-EYE increased the ADR in comparison with SC [22 (100%) vs 9 (13%) ] respectively as G-EYE colonoscopy detected an additional 15 adenomatous polyps in 13 patients missed from SC colonoscopy. The difference was statistically significant. Fortunately there were very few complications, abdominal pain reported in 3 cases after the end of procedures.

Conclusion
The study demonstrated that G-EYE is superior to SC in increasing adenoma and polyp detection rate as being more rapid and more precise for detection of diminutive and small adenomatous polyps. However G-EYE could not be done in certain conditions such as diverticulosis, masses, ulcerations or colonic strictures for fear of perforation or incomplete intubation, in this study those patients were excluded from the start as the aim of the study was polyp detection rate difference by balloon assisted colonoscopy (G-EYE) in comparison to the standard colonoscopy (SC).
Correlation between Plasma PCSK9 and Blood Lipids in Patients with Newly Diagnosed Primary Nephrotic Syndrome
Authors: Elshinnawy Howayda Abdelhamid , Gharib Mohamed Sary , Fahmy Abubakr Mohamed 
Published: August 2023

Abstract

Background
Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a major post-transcriptional regulator of low-density lipoprotein receptor degradation. Recently, PCSK9 was shown to be overexpressed by liver cells in rats with proteinuria. However, the levels of PCSK9 in newly diagnosed primary nephrotic syndrome (PNS) patients and correlations involving PCSK9 and blood lipids are not clearly understood.

Aim of the Work
The aim of this study is to assess the association between plasma pcsk 9 and blood lipids in patients with newly diagnosed primary nephrotic syndrome

Patients and Methods
This was a case control study in Ain Shams University hospital for 4 months on 50 patients, 35 control.

Results
in our study elevated plasma PCSK9 levels had a positive linear correlation with elevated serum TC (p value &lt;0.001) and LDL-C (p value &lt;0.001), triglycerides (p value 0.003), HDL (p value 0.012), VLDL(p value 0.001) A comparison of plasma PCSK9 levels of MCD, MN And primary focal segmental patients showed that they were not significantly different (p value 0.954). In our study, we found that the plasma levels of pcsk9 were significantly higher than in healthy controls 314.580 ± 73.835 ng/ml vs 253.429 ±36.666, and this difference was statistically significant P-value &lt;0.001. In our study plasma PCSK9 levels in patients with PNS had no linear correlation with the amount of proteinuria per 24 h, p value 0.070 or with albumin p value 0.549 and there was no statistical difference between the the two groups of proteinuria (3.5-8 (g)/24 h vs &gt; 8 (g)/24 h) p value 0.378.

Conclusion
Plasma PCSK9 levels in newly diagnosed primary nephrotic patients were markedly increased and positively correlated with total cholesterol, VLDL, LDL, HDL. suggesting that PCSK9 may emerge as a novel therapeutic target in nephrotic syndrome associated hypercholesterolemia
Evaluation of a Clinical Outcome of Resistant Gastroesophageal Reflux Disease after Treatment with Full Thickness Endoscopic Device
Authors: Bayoumy Essam Mohammed , Ahmed Gada Abd Elrahman , Galal Salah Shaarawy , Amer Ayman Mohamed Yousef 
Published: August 2023

Abstract

Introduction
The full-thickness Plicator® (Ethicon Endosurgery, Sommerville, NJ, USA) was developed for endoscopic treatment of gastroesophageal reflux disease (GERD). The goal is to restructure the antireflux barrier by delivering transmural pledgeted sutures through the gastric cardia. To date, studies using this device have involved the placement of a single suture to create the plication,

Aim of the Work
To evaluate clinical efficacy of endosural suturing using gastroscope for patients with resistant GERD,

Patients and Methods
This is A Prospective study, was carried out on 25 adult patients having resistant GERD or Hiatus hernia at Gastroenterology outpatient's clinic, endoscopic center, From September 2020 to March 2020,

Result
According to Endoscopy, there were 20 with Esophagitis in found GERD, and 1 case with Incompetent cardia in no GERD finding,

Conclusion
Endoscopic full-thickness plication using the GERDx™ device improves the distal acid exposure of the esophagus, typical reflux-related symptoms and QoL in well-selected patients. This procedure might constitute an option for patients with mild GERD. Long-term outcomes are required to expand our knowledge on the effects of this procedure,
Evaluation of a Clinical Outcome of Resistant Gastroesophageal Reflux Disease after Treatment with Full Thickness Endoscopic Device
Authors: Monis Ahmed Ali , Anwar Ayman Gamil , Galal Salah Shaarawy , El Aziz Emam Emam Gamal Abd 
Published: August 2023

Abstract

Background
Gastroesophageal reflux disease (GERD) is one of the most prevalent gastric disorders, defined as a condition in which reflux of gastric and duodenal contents back into esophagus causing troublesome symptoms and complications impairing quality of life.

Objective
To evaluate clinical efficacy of endosural suturing using gastroscope for patients with resistant GERD.

Subjects and Methods
This study is a prospective study. This study was carried out at Gastroenterology outpatient's clinic, endoscopic center of Ain Shams University Hospitals. The study was performed from September 2019 to December 2020. 25 adult patients having resistant GERD or Hiatus hernia.

Results
In our results we found that there was highly statistically significant difference according to symptoms grade between before treatment and after treatment. In our study we cleared that according to CBC, the mean of Hb 12.89 (± 0.80 SD), the mean of RDW 13.40 (±0.95 SD), the mean of platelets (*1000) 239.76 (± 60.37 SD), mean of RBCs 5.19 (± 0.51 SD). In study in our hands we found that there is highly statistically significant according to hill grade between before treatment and after treatment.

Conclusion
Our study has shown that endoscopic suturing of the gastroesophageal junction has significant improvements in reflux control that is sustained to 6 months and significant improvement in quality of life after procedure and significant reduction in symptoms severity after procedure.
Platelet to Lymphocyte Ratio and Neutrophils to Lymphocyte Ratio as Potential Markers for Lupus Nephritis Flares
Authors: Farres Mohamed Nazmy , khodree Mayada Moneer Mahmoud El , Fouad Shaimaa Hany , Mansour Eman Salah Abdel Shafi 
Published: August 2023

Abstract

Background
Systemic lupus erythematosus is chronic autoimmune disorder with variable clinical presentations and multi-organ involvement. The disease has female predominance and unpredictable course.

The aim of this study
was to measure platelet to lymphocyte, neutrophil to lymphocyte ratios in patients with lupus nephritis.

Subjects and Methods
This study was conducted on patients of lupus nephritis either in Nephrology clinic& Dialysis unit or admitted as inpatient in Ain Shams university Hospitals. For 60 Patients as two groups; the first group includes 30 SLE patients with ESRD. The second group includes of 30 lupus, and 3rd group 30 control healthy group.

Results
A highly significant difference was observed between lupus nephritis patients and healthy controls regarding neutrophil to lymphocyte ratio (p &lt; 0.001)

Conclusion
In conclusion, NLR appear to be potentially useful biomarkers in lupus nephritis patients for disease activity and damage-compared with the other inflammatory cytokines as IL-6. Being easily obtained and cheap, they can be applied as predictors of not only disease activity and damage but also relapse and remission in lupus nephritis patients before applying other expensive and invasive measures. Dangerous disease activity and flares in SLE are unpredictable and represent a challenge in clinical practice.