bluuebunny/crossref_metadata_2025_split huggingface dataset:
Usefulness of Diffusion Weighted MRI in Differentiating Benign from Malignant Bone Lesions
Authors: Kamel Faten Mohamed Mahmoud , Wahby Hemada Tarek , Ali Mai Mohamed Mohamed 
Published: August 2023

Background
Bone tumors represent a wide spectrum of disease in children & adult ranging from benign lesions to an aggressive malignancy, so finding a noninvasive diagnostic tool was needed.

Objective
We aimed to differentiate between benign and malignant bone lesions and to limits the number of patient with benign lesion who undergo biopsy.

Patients and Methods
Our study was carried out on 32 patients were diagnosed with bone tumors (21 benign & 11 malignant), at the MRI unit of the Radiology Department Ain Shams University, outpatient clinics and private centers after getting approval from each ethical committee. They were assessed with conventional & diffusion MR images, DW EPI carried out using different b values including 0 s/ mm², 500 s/ mm², and 800 s/ mm². ADC map were automatically calculated.

Results
The mean ADC value for benign tumors was 1.6±0.4 x 10 -3 mm2/s. while malignant tumors were 1.2±0.3 x 10 -3 mm2/s. ROC analysis was used to define the best cut off mean ADC value for detecting malignancy which was &lt;1.3, with sensitivity of 81.8% specificity of 81%.

Conclusion
The present study showed high specificity and sensitivity of DWI as a complementary sequence with conventional MRI and ADC value measurements in discrimination between benign and malignant bone tumors with significant cut-off value, making it a noninvasive tool for increasing the accuracy in identifying bone lesions.
Ultrasound Tracking of Fetal Growth Characteristics during the Third Trimester of Pregnancy and the Prediction of Adverse Birth Outcomes
Authors: Mohamed Safaa Kamal , ELdeen Mohamed Hend Galal , Georgy Michael Saber Nan 
Published: August 2023

Background
Fetal growth is the outcome of complex interactions between genes and the environment. A human being undergoes a synchronized balance of growth and development of body proportions throughout the prenatal and postnatal phases. Fetal growth is affected by many factors including maternal sociodemographic, maternal lifestyle-related characteristics, and pathological conditions, such as infections and some genetic conditions.

Objective
To assess the role of 3rd trimester ultrasound and fetal growth measurements in the prediction of adverse birth outcomes.

Patients and Methods
This study was a prospective cohort study of 141 pregnant females, conducted at Ain Shams University Hospitals.

Results
HC, AC, Expected fetal weight, HC percentile and weight percentile were significantly higher in normal cases than still birth, preterm, neonatal death and SGA, and lower than fetal macrosomia. AC percentile was significantly higher in normal cases than preterm, neonatal death and SGA, and lower than fetal macrosomia.

Conclusion
Fetal biometric and Doppler measurements during the third trimester of pregnancy play an important role in early detection of adverse growth outcomes in order to initiate further monitoring, planning and managing of delivery.
Mechanical Thrombectomy by Stent Retrievers for Treating Acute Ischemic Stroke due to Large Vessel Occlusion
Authors: Ismail Mohammad Amr Mohamed , Gamal-eldin Mostafa Mahmoud , Ibrahim Ayman Mohamed 
Published: August 2023

Background
Recently multiple studies have evaluated the role of mechanical thrombectomy in treatment of acute ischemic stroke & demonstrated that it has a favorable impact on the functional outcome in patients with acute ischemic stroke related to proximal arterial occlusion. In addition to that, multiple systematic reviews and meta-analyses analyzed the results of these recent Randomized Control Trials and concluded that endovascular treatment is more likely to result in a better functional outcome for patients compared to IV thrombolysis alone for acute ischemic stroke due to large vessel occlusion, with no differences in mortality and symptomatic intracerebral hemorrhage at 90 days follow-up. Mechanical approaches have shown great potential of replacing locally applied thrombolytic agents as first-line therapy.

Objectives
The aim of work is to evaluate the safety and efficacy of endovascular treatment (EVT) of acute large vessel occlusion within the first 6 hours of symptoms onset, including bridging therapy [intravenous thrombolysis (IVT) with subsequent EVT]. We also compare our results to other main trials in recent years.

Methods
A one arm clinical trial was conducted on 25 patients with acute ischemic stroke at Ain Shams University hospitals as well as private centers, from the first of April 2020 to the end of September 2020. All participants subjected to full history taking, radiological assessment and assessment of the stroke severity.

Results
The median age of the studied patients was 64 years (Interquartile range 58-72.5) and about half (56%) of them were males. On pre-post intervention comparison, there was a highly significant statistical difference regarding NIHSS score, infarct volume, mRS score at 90 days (P &lt; 0.001) and ASPECTS (P &lt; 0.01) of the studied patients. 12% of patients had mortality at 30 days after mechanical thrombectomy with good functional outcome (mRS 0-2) rate of 60%.

Conclusion
Mechanical thrombectomy is effective and safe in treatment of acute ischemic stroke in patients with large cerebral artery occlusion with the first 6 hours of symptoms onset.
Non-Alcoholic Fatty Liver Disease-Associated Hepatocellular Carcinoma: Effect of Hepatic Steatosis on Major Hepatocellular Carcinoma Features at MRI
Authors: Botros Samer Malak , Ahmed Khaled Sayed , Ismail Mohamed Zaki , Ali Waseema Kamal Ibrahim Hassan 
Published: August 2023

Background
Non-alcoholic fatty liver disease has become the leading chronic liver disease in the developed world, with a prevalence of 6%-35%. Its pathological spectrum ranges from simple steatosis (non-alcoholic fatty liver) to different degrees of inflammation and liver cell damage [nonalcoholic steatohepatitis (NAFLD)]. NAFLD has gained attention in recent years because of its association with hepatocellular carcinoma (HCC).

Objective
To see how hepatic fat fraction affects LIRADS major hepatocellular carcinoma features on magnetic resonance imaging.

Patients and Methods
Our study included 60 patients who had had a liver MR scan and exhibited MRI features in keeping with HCC. We categorize the patients into two groups: hepatic steatosis and non- hepatic steatosis groups based on MRI hepatic fat signal fraction. LI-RADS major and ancillary features were evaluated in all HCCs. Between October 2021 and April 2022, a retrospective search was conducted to find all patients with HCC who underwent an MRI of the liver at the radiology department of Ain Shams University's Faculty of medicine.

Results
In the current study, a higher proportion of HCCs show non- enhancing capsule in patients with hepatic steatosis; 5 HCC (5/30; 16.7%), while in the non-hepatic steatosis group no HCCs 0 (0%) showed non-enhancing capsule. The effect of ancillary features on diagnostic accuracy is still being researched. As regards the impact of the degree of fatty liver on the major and ancillary HCC features, the “enhancing capsule”, “mild-moderate T2 hyperintensity” and “restricted DWI” features are less commonly seen in cases of moderate to severe hepatic steatosis than in those of mild hepatic steatosis. Our study also showed that HCCs tends to be of a smaller size as the hepatic steatosis degree increased.

Conclusion
The findings of our retreopective study are coincide with a recent retrospective studies demonstrated that “enhancing capsule” feature of HCC was less frequently observed in patients with hepatic steatosis compared to non-hepatic steatosis patients. We compared the MRI features of HCC in patients with hepatic steatosis to those in patients without hepatic steatosis. Our findings imply that existing imaging criteria for the noninvasive characterization of HCC in individuals with hepatic steatosis should be utilised with care.
Effect of Genetic Polymorphism on Clinical Efficacy of Tacrolimus in Adult Living Donor-Liver Transplant Patients
Authors: El-Moez Amal Tohamy Abd , Askar Safaa Ragab Tawfik , Mansy Azza El-sayed , Kamal Abobakr 
Published: August 2023

Background and Aim
The influence of genetic polymorphism on the clinical outcome including response and safety of immunosuppression in liver transplant (LT) recipients remains controversial among different races and ethnicities, especially for calcineurin inhibitors (CNIs). This study aims to evaluate the effect of different genotypes of the single nucleotide polymorphism (SNP) in the genes encoding CYP3A5 on the therapeutic response to the widely used calcineurin inhibitor; tacrolimus.

Method
In 49 living donor liver transplant (LDLT) recipients with tacrolimus as the backbone immunosuppressive, the rejection, delayed graft function, laboratory evidenced nephrotoxicity, new onset diabetes and hypertension rates were considered the primary therapeutic and safety outcomes of tacrolimus. The biochemical parameters of tacrolimus response and safety as evidence by the status of liver functions, renal functions, complete blood counts and serum electrolytes, as well as the need for Mycophenolate mofetil (MMF) were considered the secondary outcomes.

Results
the rejection and delayed graft function rates didn’t differ significantly among different genotypes (p = 1), similarly; the incidence of new onset diabetes and hypertension didn’t differ significantly among different genotypes (p = 1, and 0.4143 respectively). Moreover; laboratory evidenced nephrotoxicity rates didn’t differ significantly among different genotypes (p = 0.5040). No significant intergenotype differences were observed in the all biochemical outcomes. However the need for MMF was significantly higher among carriers of the CYP3A5*3 allele.

Conclusion
different genotypes did not offer an advantage over one another in predicting therapeutic response or toxicity of tacrolimus among LDLT recipients.
Sarcopenia as a Predictor of Prognosis and Risk of Recurrence in Patients Following Curative Treatment for Hepatocellular Carcinoma
Authors: AlBreedy Ashraf Mohammad Mahmoud , Salah el-din Manar Mohamed , El-Sadaney Mohamed Taha Hassan 
Published: August 2023

Purpose
This study is designed to evaluate the prognostic value of sarcopenia as a predictive method for survival of patients with hepatocellular carcinoma (HCC) who will receive curative treatment.

Methods
To determine the influence of sarcopenia on prognosis, skeletal muscle index (SMI) was measured using computed tomography at the level of the third lumbar vertebra of 100 patients who underwent radiofrequency for hepatocellular carcinoma (HCC). They were followed up for at least 7 months and overall survival and recurrence were identified. We defined sarcopenia using cutoff values for SMI as less than 43.75cm /m for men and 41.10cm /m for women.

Results
Sarcopenia was present in 54 of 100 patients and correlated significantly with low body mass index (BMI) and DM. Sarcopenia and MELD Na score were significantly associated with poor survival of the patients.

Conclusions
The study concluded that sarcopenia seemed to have a negative impact on OS in patients with HCCs. Sarcopenia could significantly increase the incidence rates of post-treatment recurrence and overall complications in patients with HCCs.
Clinical Trends of Malaria in Abbasia Fever Hospital over a Period of Two Years
Authors: Fawzy Montaser Mohammed , Emara Sally Moustafa Mahmoud , Eldin Mona Soliman Zein , Salah Eldin Manar Mohammed 
Published: August 2023

Background
Malaria is an acute systemic illness caused by infection with Plasmodium parasites that lives part of its life in humans and part in female Anopheles mosquitoes. It remains one of the major killers of humans, population worldwide.

Objective
To study clinical trends and prevalance of malaria in Abbasia Fever hospital over a period of two years.

Patients and Methods
This study was conducted in co-operation between Tropical Medicine Department, Faculty of Medicine, Ain Shams University and Abbasia Fever hospital. The current study was conducted on 200 Malarial patients admitted to Abbasia fever Hospital in Cairo (time) to be treated according to the protocol of treatment of malaria which was approved by Ministry of Health in Egypt.

Results
According to the treatment of malaria, the present study revealed that the best response in studied cases was to the mono-therapy. Concerning the clinical outcome of the studied cases, most of the studied cases (189 patients) were cured in the sense of clinical and parasitological improvement. Regarding comparative results among the studied cases, complicated malaria was more frequent in male and non-Egyptian and pregnant women.

Conclusion
Malaria should be considered as a cause of fever in relevant target patients. Malaria disease is commoner in the younger ago group. In Egypt, no endogenous malaria cases have been reported since1998 until 2014 a malaria outbreak was discovered in Aswan. Malaria cases in Egypt are usually coming from endemic area in Africa. Mortality due to malaria disease is unusual, and may result from improper chemoprophylaxis and missed diagnosis or late treatment. Monotherapy is preferable than Combined therapy (polytherapy) as it is more effective among the studied malarial cases. Tools of prophylaxis are insect repellents, protective clothes, bed nets and chemoprophylaxis.
The Outcome of Ulcerative Colitis Patients after One Year of Biological Therapy
Authors: El-Aziz Ashraf Amin Abd , Askar Safaa Ragab Tawfic , Ahmed Yasmeen Abdel-latif , Abokhatwa Nadeen Ashraf Ahmed 
Published: August 2023

Background
Inflammatory bowel disease (IBD) comprises two types, namely, the ulcerative colitis (UC) and Crohn’s disease (CD). They are a spectrum of chronic idiopathic autoimmune inflammatory disorders with remission and relapses, primarily affecting the gastrointestinal system, UC is characterized by confluent mucosal inflammation and erosions starting from the anal verge and extending to a variable extent, where Patients often complain of diarrhea associated with rectal bleeding, abdominal tenderness, and weight loss A number of biological agents have been approved by the U.S Food and Drug Administration (FDA) for te treatment of UC.

Objectives
The aim beyond this study is to assess the effect of biological therapy after one year on ulcerative colitis patients regarding clinical manifestations, hospitalization, number of severe attacks, laboratory investigations, colonoscopy and histopathology.

Patients and Methods
The studied patients were selected from patients presented to IBD study group clinic.tropical medicine department in Ain Shams University hospitals. total number of cases during the study period was 28 cases fulfilling the inclusion criteria.

Results
The mean age of the patients was 30.14 ± 7.65. The majority of the cases were sightly more common in females. The duration of illness ranged from 1-10 years with median 3 years (2 - 5.5). the majority of the patients had pan colitis (75%). there were 19 biologic-naive patients (67.9 %) and 9 biologic-experienced patients (32.1%). In our study, 16 patients (57.1%) received adalimumab, 11 patients (39.3%) received infliximab and only one patient received ustekinumab. The majority of cases (71.4%) were taking azathioprine as a combination therapy with biologics. the majority of the patients (75%) achieved clinical response at 1-year follow-up.While clinical remission achievied in only 46.4%

Conclusion
Biological treatments are very successful in the therapy of IBD. However, these treatments are still expensive and new patients with IBD must begin first with the traditional treatments without knowing if they will work for them.
Non Invasive Biomarkers for Non-Alcoholic Fatty Liver Disease in Egyptian Obese Patients Undergoing Bariatric Surgeries
Authors: Taher Sarah Hassan , El Mahdy Manal Mohamed , Zaki Doaa Zakaria , Al-Hamid Mohamed Salaheldin Abd , Naga Mohamed Ahmed Aboul , Barakat Eman Mahmoud Fathy 
Published: August 2023

Background
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the worldwide occurring in 33 % of the general population and in over 90% of the patients with morbid obesity that are undergoing bariatric surgery. NAFLD encompasses a histological spectrum ranging from simple steatosis (NAFLD) to nonalcoholic steatohepatitis (NASH) with various degrees of fibrosis that may progress eventually to cirrhosis. A key issue for the prognosis and management of NAFLD is the differentiation of simple steatosis from NASH. To date, liver biopsy remains the best gold standard for diagnosing NASH and grading the severity of liver damages but it is invasive procedure. There is an urgent need for a less invasive method than biopsy of screening the population, stratifying disease severity and following disease progression.

Aim of the Work
To evaluate promising non-invasive predictive biomarkers used to distinguish between NASH and simple steatosis in morbidly obese patients undergoing bariatric surgery.

Patients and Methods
This was a case control study conducted in morbidly obese patients before they had gone bariatric surgery between January 2018 and January 2020 with a total number of 30 patients.
We included morbidly obese patients (BMI≥40 kg/m²) undergoing bariatric surgeries. Liver biopsies were obtained at time of bariatric surgery and examined by single pathologist and graded according to NAFLD activity score (NAS),

Results
This study was conducted on 30 patients who were morbidly obese before they had gone bariatric surgery at Ain Shams University Hospitals. Among the 30 patients, 21 of them diagnosed as NASH by the liver biopsy, 42.9% of the NASH patients were diabetic, and 47.6% of them were hypertensive. The BMI and hip circumference were highly significant with NASH with cut off level of BMI &gt;42.6 and 85.71% sensitivity and 66.67% specificity. Using AUC analysis, we established for these parameters the following cutoff levels being indicative of NASH with the highest accuracy (equal or above): BMI of 42.6 kg/m2, HOMAIR of &gt; 3.6. For adiponectin, a value equal or below 2.9 mg/L was indicative of NASH and hs-CRP of above 1.5 mg/L.

Conclusion
BMI&gt; 42.6 kg/m², HOMA-IR, adiponectin, hs-CRP are good non- invasive indicators for NASH in morbidly obese patients undergoing bariatric surgeries.
Co-Relation between MELD Scoring System prior Living Donor Liver Transplantation and Occurrence of Post-Transplant Biliary Complications
Authors: Hussein Mubarak Mohamed , Abdelwahab Sameh Mohamed , Dabbous H , Montasser Iman Fawzy , Al-Banna Wael M 
Published: August 2023

Background
Liver transplantation is considered the treatment of choice for patients with end stage liver disease who have failed standard medical and surgical therapy. The development of liver transplantation has revolutionized the field of hepatology and greatly improved the outlook of patients suffering from various liver diseases. The Model for EndStage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease. It was initially developed to predict mortality within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure and was subsequently found to be useful in determining prognosis and prioritizing for receipt of a liver transplant. This score is now used by the United Network for Organ Sharing (UNOS) and Eurotransplant for prioritizing allocation of liver transplants instead of the older Child-Pugh score. Biliary tract complications are abundantly occurring post-operative, and they may include a variety of scenarios, as biliary leakage, ischemic bile duct injuries, and biliary stenosis.

Aim of the Work
Aim of the work is to study the relation between the Model of End Stage Liver Disease (MELD) scoring system and the occurrence of post liver transplantation biliary complications.

Patients and Methods
A combined retrospective and prospective cohort study was carried out. We retrospectively analyzed the available database of all patients that underwent LDLT, at Ain Shams Center of Organ Transplantation (ASCOT), during the period from January 2013 till May 2019, and suffered from post-operative biliary complications during the first 3 months Post-operative and correlated it with their MELD score before the operation. To do so, we studied 50 patients that are aged more than or equal 18 years old, any gender, that underwent living donor liver transplantation. We excluded patients with cholestatic liver disease and patients that underwent preoperative biliary intervention. All patients were subjected to complete history taking and thorough clinical examination, full laboratory workup, full radiological workup, post-operative cholangiography and Endoscopic retrograde colangio-pancreatography if needed.
Randomized Clinical Trial to Evaluate the Efficacy of Tamsulosin, Solifenacin, and Their Combination for the Treatment of Stent Related Symptoms
Authors: Kotb Youssef Mahmoud , Salem Ahmed Farouk , Hassan Ahmed Abd Elsalam Embaby 
Published: August 2023

Background
Ureteral stents play a major role in a wide range of situations where urinary drainage is needed, the double-J stent which is the most common form of ureteral stent, has been used in obstructive pyelonephritis, intolerable acute renal colic, ureteral edema, ureter perforation following endoscopic procedures, and renal failure secondary to ureteral obstruction. Despite the usefulness of stents, some of the patients might encounter stent-related complications such as urinary tract infection (UTI), lower urinary tract symptoms (LUTS), stent-related body pain, and hematuria. These symptoms represent a prevalent problem with considerable effects on the quality of life, substantial general health, work performance, and sexual performance in both genders. For this reason, several attempts to minimize stentrelated symptoms have recently been reported. Pharmacologic management is one of these trials, especially the prescription of selective alpha-1-blockers as tamsulosin and antimuscarinic agents as solifenacin.

Aim of the Work
To analyze and assess the effectiveness of a selective alpha-1-blocker (tamsulosin) and antimuscarinic (solifenacin) and their combination in improving the lower urinary tract symptoms of patients with indwelling double-J ureteral stents.

Patients and Methods
The present study was a prospective randomized controlled comparative study conducted on 112 patients with double-J stent inserted in Ain Shams University Hospital and El-Agouza hospital. over a period of 6 months. The patients were randomized into 4 equal groups (1:1:1:1 randomization): Group A: 28 patients were received a daily oral dose of pepon plus as a placebo drug (control group). Group B: 28 patients were treated by Tamsulosin (0.4 mg) alone once daily. Group C: 28 patients were treated by Solifenacin (5 mg) once daily. Group D: 28 patients were treated by Tamsulosin (0.4 mg) once daily in combination with Solifenacin (5 mg) once daily. All patients were assessed first day postoperatively after Double-J stent insertion. Then, the patients were start the medical treatment and were assessed on the first and third week post treatment.

Results
The study show that the combination of the tamsulosin 0.4 mg/day and the solifenacin 5 mg /day are significantly different from tamsulosin only, solifenacin only and placebo groups. Generally superior to the all other groups for the stent related symptoms treatment. However, regarding the comparison between solifenacin only group and tamsulosin only group, the solifenacin only group was generally superior to tamsulosin group and both are better than placebo group.

Conclusion
The combination of the tamsulosin 0.4 mg/day and the solifenacin 5 mg /day are generally superior to the all other treatments for the stent related symptoms.