bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Shock Wave Frequency on Stone Disintegration in Extra Corporeal Shock Wave Lithotripsy
Authors: Agour Abdefattah , Radwan Ahmed , Zahra Ahmed Ali 
Published: August 2023

Background
The use of Shock Wave Frequency (SWL) for the treatment of renal stones has brought a revolution in the field of urology. Not only has it decreased hospitalization duration and morbidity, but it has also shown to be cost-effective. SWL treatment is noninvasive, doesn't require anesthesia, and may be done in outpatient settings. As a result, when it comes to treating renal and upper and middle ureteric stones, ESWL is still the best option.

Objective
To evaluate of the effect of shock wave frequency on treatment outcomes in terms of success and complication rates.

Methods
This is a prospective study conducted on 135 patients with renal stone planned to have ESWL sessions attending urology outpatient clinic in Ain Shams University and Misr University for Science and Technology hospitals. Patients were recruited from the outpatient clinic from age 18 years to 70 years old with renal or upper ureteric stone who are candidate for ESWL. Patients were assigned to 3 equal groups who received the same number of shock waves (3000 shock waves) with different shockwave frequency.

Results
The results revealed that there was no statistically significant difference found between the three studied groups regarding age, sex, BMI, side, site, size of stone and house field unit (density of stone). As regard sensation of pain during session, there was difference between patients’ groups where pain sensation increases as the frequency rate increase. But there was no statistically significant difference found between frequency 60 and frequency 90 groups regarding pain score. While there was statistically significant increase in the pain score in frequency 120 group than the other both groups 60/min and 90/min. There was no statistically significant difference found between the three studied groups regarding results of stone clearance.

Conclusion
Extra corporeal shock wave lithotripsy (ESWL) is still one of the most effective methods in treatment of upper urinary tract stones. It also remains the only truly non-invasive treatment in renal and upper ureteric stone diseases. There is evidence that modifying lithotripsy parameters like frequency of disintegration is strongly related to the outcome of the treatment. Intermediate shock wave frequency (90/min) is associated with highest success rate (95.3%) followed by the low frequency group (60 /min) and both are better in outcome than high frequency (120/min). With increasing the frequency of disintegration, duration of session decrease with pain sensation during the treatment increase. Highest shock wave frequency (120/min) is associated with lowest success rate as well as highest pain sensation during session.
Comparison between Tadalafil and Tamsulosin in Reliving Stent Related Symptoms: A Randomised Study
Authors: Abdallah Hany Mostafa , Mohamed Mohamed Hassan , Riad Mina Murad 
Published: August 2023

Background
Ureteroscopy had been recognized as a major method for treating ureteric calculi. Although invasive, the development of smaller and more flexible ureteroscopes, and a new generation of various intracorporial lithotripters, has made this procedure safer and more effective. Placing a ureteric stent after ureteroscopy with stone extraction is done by some urologists routinely to prevent possible stenosis or to decrease secondary pain caused by mucosal oedema.

Objective
To evaluate and compare the efficacy and safety of Tadalafil and Tamsulosin in reliving Double-J stent-related symptoms following uncomplicated ureteroscopic lithotripsy (URSL) and percutaneous nephrolithotomy (PCNL).

Patients and Methods
The present study was a prospective randomized comparative study conducted on 80 patients (56 men and 24 women) with double-J stent inserted following uncomplicated ureteroscopic lithotripsy (URSL) and unilateral percutaneous nephrolithotomy (PCNL) in Ain Shams University Hospital and Sohag Educational hospital over a period of 1 year.

Results
The study shows that Tadalafil is safe and effective in relieving DJ related symptoms. Tadalafil 5 mg once / day is as effective as Tamsulosin 0.4 mg once / day in relieving urinary symptom and body pain but more effective in relieving sexual symptoms and general health.

Conclusion
The study shows that Tadalafil is safe and effective in relieving DJ related symptoms. Tadalafil 5 mg once / day is as effective as Tamsulosin 0.4 mg once / day in relieving urinary symptom and body pain but more effective in relieving sexual symptoms and general health. Therefore Tadalafil 5 mg once / day could be recommended as preferred drug in sexually active patients undergoing DJ stenting.
Efficacy and Safety of Different Modalities for Treatment of Erectile Dysfunction in Chronic Renal Failure Patients
Authors: Zakher Mina Nageh , El Fattah Agour Abd , Hassan Ahmed Tawfick 
Published: August 2023

Background
Erectile dysfunction has been found to be significantly more common in men with chronic kidney disease (CKD) than in the general population.

Objective of the Study
Detection of the safest and most effective medical treatment of erectile dysfunction(ED) in chronic renal failure patients.

Patients and Methods
. This study was conducted at Ain Shams University Hospitals with a sample size of 60 patients: 15 patients per group. We assessed the improvement in the erectile function through assessment of IIEF (International Index of Erectile Function) score and EHS (Erection Hardness Scale) score pre- and post-administration of the drugs used in the study (oral sildenafil, oral vardenafil, oral tadalafil and intracavernosal injection of alprostadil).

Results
There is a statistically significant increase in IIEF score post-administration of the drugs used in this study with p value of &lt; 0.001 and a mean difference of 6.92. The mean score of IIEF pre-administration of the drugs used was 8.13 and post-administration was 15.05. There is also a statistically significant difference in EHS score with p value of &lt; 0.001 and mean difference of 1.4. The mean score of EHS pre-administration of the drugs was 1.22 and post-administration was 2.62. From the four drugs used in this study, Alprostadil showed the highest improvement in IIEF and EHS scores. The study also showed a negative correlation between age, duration of haemodialysis and serum creatinine with erectile function. In addition, there was a statistically significant decrease in pre- and- post-treatment IIEF and EHS scores in diabetic cases than in the non-diabetic cases.

Conclusion
There is high incidence of ED in CKD patients. The drugs used in the study showed improvement in the erectile function with mild side effects. Alprostadil had the best IIEF and EHS scores amongst the four drugs.
Uretroscopy with Laser vs ESWL in Management of Upper Ureteric Stones
Authors: Maged Wael Ali , Ahmed Mahmoud Mahmoud , Ismail Mohamed Gamal Mohamed 
Published: August 2023

Background
Although SWL and Laser remain the most common modalities for the treatment of proximal ureteral stones, there is still an ongoing debate among the academicians and medical practitioners regarding the best treatment modality.

Objective
To compare the efficacy of ureteroscopy using holmium: YAG laser lithotripsy versus shock wave lithotripsy in management of proximal ureteric stones (≤10 mm) regarding surgical efficacy, safety and cost effectiveness.

Patients and Methods
This study was performed to compare ureteroscopy using holmium: YAG laser lithotripsy versus shock wave lithotripsy in management of proximal ureteric stones (≤10 mm) regarding surgical efficacy, safety and cost effectiveness. It included 52 patients with proximal ureteral stones and it was done in the period starting from September 2021 to February 2022.

Results
There was a statistically significant difference between the both modalities in favor of SWL as regarding the anesthesia, the overall procedural time and overall cost as SWL group were treated as an outpatient cases. There was a significant difference in used anesthesia (sedation for SWL and general anesthesia for Laser). Regarding Overall procedural time (hours), it was 4.55 ± 1.94 and was 36.88 ± 5.38 for SWL and Laser groups respectively. Overall cost; even if patients underwent three sessions of SWL, the cost between the two options was still significantly different. The overall cost of Laser was 15000 EP, with an efficiency of 80 %, while overall cost of SWL was (2500 EP), with an efficiency of 49.9 %.

Conclusion
Laser is more effective, has the advantage of the higher SFR from the first session without need of multiple hospital visits and prolonged radiation exposure time. SWL has lower treatment costs, while complications were comparable in both groups, so treatment decision depends on not only stone characteristics but also cost-effectiveness ratio and this should be considered when counseling the patient with proximal ureteric stone. Larger sample size is required for more convenience data.
The Role of Renal Parenchyma to Hydronephrosis Area Ratio (PHAR) in Evaluation of Ureteropelvic Junction Obstruction in Children
Authors: Kotb Youssef Mahmoud , El Naga Mohamed Abdelmoneim Abu , El Hamid Waleed Mohamed Abd 
Published: August 2023

Background
The cortex/ pelvis ratio or parenchymal to pelvicalyceal area ratio can help initial evaluation and follow up of the children with uretropelvic junction obstruction as simple modality using the cut off which is 1.6 (pelvis/ cortex) ratio. There are many studies evaluating the various preoperative parameters which influence the post-operative outcomes after pyeloplasty. Practically there are many ultrasound parameters in the post-operative period which indicate the change in renal function. So, our rationale in this study is to evaluate the role of the parenchyma hydronephrosis area ratio (PHAR) in initial evaluation and follow up of UPJO patients in correlation to renal isotope studies.

Objective
To evaluate sonographic assessment of Renal Parenchyma to Hydronephrosis Area Ratio (PHAR) in the initial management and follow up of UPJO patients in correlation with the renal scan.

Patients and Methods
Site of the study: All patients were selected from the children who attended our outpatient department and have proven UPJO and meeting the criteria for the need of surgical intervention at Faculty of Medicine, Ain Shams University. Sample Size: 36 patients. Using PASS II Program for sample size calculation and according to (Rickard et al,2016), the expected AUC for PHAR prediction of future surgical intervention = 0.18, 30% rate of surgical intervention, setting power at 8% and error at 0.05, sample size of 36 patients will be needed.

Results
We enrolled 36 cases of children ≤ 16 years old (7.93 ± 0.83) with unilateral UPJO. Preoperative ultrasound parameters of the hydronephrotic kidneys [including degree of hydronephrosis, parenchymal thickness and PHAR] and renal isotope are measured & compared with the same parameters after surgical repair of the UPJO (Anderson Hynes pyeloplasty) at 3rd months. After operation, 31 cases (86.1%) improved & 5 cases not improved (13.9%). We find a significant change in all parameters at 3 months postoperatively (p &lt; 0.01) as T ½ (25.22 ± 2.49 & 17.57 ± 3.84) significantly decrease & parenchymal thickness (9.42 ± 4.92 & 15.12 ± 4.86), GFR of the affected kidney (34.31 ± 3.31 & 48.32 ± 6.99) split renal function (37.30 ± 3.80 & 44.03 ±4.11) and PHAR (0.86 ± 0.30 & 2.45 ± 0.93) significantly increase post operatively. PHAR post operatively shows positive correlation with parenchymal thickness & renal isotope while negative correlation with T ½.

Conclusion
PHAR is a promising parameter that can be estimated on presentation US to help predict the future need for surgery and follow up in children with ureteropelvic junction obstruction. Early identification of children who may require surgical intervention allows for closer surveillance of those patients as well as the opportunity for more selective ordering of invasive testing.
Is Inframallolar Angioplasty Effective for Wound Healing in Patients with Critical Lower Limb Ischemia and Tibial Only Disease?
Authors: Fathy Abdelghaffar Mohamed , Salem Abdelrahman Mohamed , Abdelsattar El dieb Khaled , Mohamed Moataz Ashraf Saleh 
Published: August 2023

Background
Prevalence of PAD is approximately 3–10% in the population as a whole, with this increasing to between 15 and 20% when focusing on older patients (&gt; 70 years of age). Critical limb ischemia is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration &gt;2 weeks duration.

Aim of the Work
The aim of the study is to assess the outcome of inframallelar angioplasty in patients with multiple tibial and pedal arch disease by the impact of technical success in the form of Angiogrophically improvement of pedal arch classification and clinical success by wound healing.

Patient and Methods
In this observational prospective study; 40 patients were selected from the Ain Shams University Hospitals either at OPC or ER. Patients were subjected to Duplex study and Computerized tomography (CT) angiography for investigation. Patients were treated by balloon angioplasty. Post-intervention medical treatment included: Anti-platelet, Acetylecysitene & fluids.

Results
Incomparison between the Complete Pedal Arch(CPA), Icomplete Pedal Arch(IPA), Absent Pedal Arch (APA) show no significant change demography and different comorbidities as regard age, gender, smoking, and other co-morbitidies as diabetes, hypertention, renal insufficiency, and obesity. Comparison between 3 groups in terms of wound healing show significant differnerence between CPA(91.7%), IPA (88.9%) and APA (50%) while non significant difference between CPA and IPA. In terms of healing duration it shows non significant difference between CPA and IPA, significant difference between IPA and APA and high significance diference between CPA and APA.

Conclusion
This is a prospective observational cohort study to asses the outcome of inframallelar angioplasty in patients with multiple tibial and pedal arch disease by the impact of technical success in the form of Angiogrophically improvement of pedal arch classification and clinical success by wound healing. Our study proved that inframalleolar angioplasty play effective role in improving the foot wound healing, shortening its duration in the chronic threatening limb ischemia patients, improving limb salvage and quality of life.
Outcomes of Tibial Balloon Angioplasty in Patients with Single Tibial Runoff on Wound Healing
Authors: El Ganzoury Mahmoud Zakarya , Dosoky Atef Abdelhamid , Abdelsattar El dieb Khaled , Ramadan Ammar Mohamed 
Published: August 2023

Background
The lower extremity peripheral artery disease (PAD) is between 3 and 12 percent, and If PAD left untreated, can lead to loss of the limb and in severe cases, death. Each year, there are 500 to 1000 new cases of chronic limb-threatening ischemia (CLTI) per million population with an estimated annual cost to the UK National Health Service (NHS) of more than GBP 200 million.

Aim of the Work
The aim of this study is to assess the outcome of tibial balloon angioplasty in patients with single tibial runoff by the impact of technical success in the form of single patent tibial vessel continuous with pedal arch and clinical success by wound healing.

Patients and Methods
This a prospective observational cohort study which was done to is to assess the outcome of tibial balloon angioplasty in patients with single tibial runoff by the impact of technical success in the form of single patent tibial vessel continuous with pedal arch and clinical success by wound healing in 40 patients with CLTI due to infrapopliteal disease. Our study included forty patients who visit out patient clinic or emergency room and scheduled for angioplasty. Then their wound healing rate was followed up for 6 months after the procedure.

Results
The mean of age was 62.55 ± 7.31 years. 17 patients (42.5%) were male while 23 patients (57.5%) were female. Regarding the past medical history; current Smoking was found in 30 patients (75%). Diabetes mellitus was found in 28 patients (70.0%). hypertension was found in 32 patients (80.0%). Cardiac diseases were found in 24 patients (60%).

Conclusion
This is a prospective observational cohort study to assess the outcome of tibial balloon angioplasty in patients with single tibial runoff by the impact of technical success in the form of single patent tibial vessel continuous with pedal arch and clinical success by wound healing. Our study proved that single tibial angioplasty has effective role in improving the foot wound healing, shortening its duration in the chronic threatening limb ischemia patients, improving limb salvage and quality of life.
English translation of the first study reporting cyclical periods of increased respiration and eye and body motility during sleep in infants in 1926, with commentary
Authors: Denisova Kristina 
Published: August 2023

Abstract
This is the first English translation of the work Periodic phenomena in the sleep in children, published in 1926 in the Journal Novoe v refleksologii i fiziologii nervnoi sistemy (Vol. 2, pp. 338–345) by Maria Denisova and Nicholai Figurin; it is the first study to report data on what is currently termed rapid eye movement (REM) sleep. The authors acquired continuous quantitative respiration data, as well as, eye and body movements during sleep in children for up to 6 hours, and discovered several novel features of sleep cycles in healthy infants from birth to about 1 year of age. First, the study reports cyclical periods of increased respiration and eye and body movements, with rapid ocular movements visible under relaxed eyelids (separation: 0.5–1 mm). These observations suggest atonia of REM sleep. Second, the length of the complete cycle (alternating active and quiet sleep phases or states) is about 50 minutes, an estimate that is consistent with later work. Third, the study identifies infant-specific ordering of sleep states, with the active phase beginning after sleep onset, followed by the quiescence phase. Importantly, these published data on sleep cycles precede all published studies related to the state now termed REM sleep by about 30 years (i.e. publishing in Science and in the Journal of Applied Physiology in the 1950s by Eugene Aserinski and Nathaniel Kleitman). In the historical commentary accompanying this translation, the findings of those later works are carefully compared to the original data on respiration and ocular and body motility cycles during sleep in infants, first reported and published by Denisova and Figurin (1926).
Two Cases of Periodic Paralysis Associated With MCM3AP Variants
Authors: Oishi Tatsuya , Pagano Jennifer , Sellers Cody , Jerath Nivedita U. 
Published: August 2023

Abstract

Objectives:
Periodic paralysis is a rare genetic condition characterized by episodes of neuromuscular weakness, often provoked by electrolyte abnormalities, physiologic stress, physical exertion, and diet. In addition to mutations in genes coding for skeletal muscle ion channels, in 2019, Gustavasson et al discovered that the MCM3AP gene could be responsible for periodic paralysis. In this study, we present 2 individuals with clinical episodes of periodic paralysis who have variants in the MCM3AP gene.

Methods:
Two unrelated probands were independently evaluated with clinical, genetic, and electrodiagnostic testing.

Results:
Proband 1 is a 46-year-old man who presented with decades of ongoing episodic weakness and fatigue, clinically diagnosed with periodic paralysis and supported by electrodiagnostic studies. Proband 2 is a 34-year-old woman with a history of episodic paralysis since childhood. Genetic testing in both individuals revealed potentially pathogenic variants in the MCM3AP gene.

Conclusions:
Periodic paralysis is a condition that significantly affects the lives of those diagnosed. The results illustrate that MCM3AP gene variants can been associated with a clinical and electrodiagnostic presentation of periodic paralysis. Additional future research should focus on clarifying any relationship between these genetic variants and the disease, as well as other possible genetic causes.
The hidden diagnosis: hypogonadotropic hypogonadism unveiled in a rare Fanconi syndrome case—a case report and literature review
Authors: Zaidi Syeda Mahrukh Fatima , Siddiq Mohammad Arham , Qamar Safia , Hasan Syed Mohammad , Dua e Zehra Zaidi Syeda , Kashif Syed Muhammad , Alam Muhammad Tanveer 
Published: August 2023

Introduction and importance:
Fanconi syndrome affects kidney function, whereas hypogonadotropic hypogonadism (HH) is gonadal failure due to deficient hormones. Diagnosis involves assays and imaging, whereas treatment targets cause and fluid balance. Here, there is a reported co-occurrence in Pakistan.

Case presentation:
A 14-year-old girl presented with joint pain and developmental delay. Physical examination revealed wrist widening, genu-varum, and underdeveloped secondary sexual characteristics. Laboratory findings confirmed Fanconi syndrome and coincidental ultrasound findings revealed HH. The patient received treatment in the form of oral medications and supplements to manage the condition.

Clinical discussion:
Fanconi syndrome is a complex disorder affecting the proximal tubule of the kidneys, leading to impaired reabsorption of various substances. In this case, potential genetic and acquired causes were ruled out, including inborn errors of metabolism and heavy metal intoxication. Prolonged valproic acid use was also considered but not confirmed as the cause. The patient also presented with HH, which is unrelated but coexisting. Treatment for Fanconi syndrome focuses on correcting electrolyte imbalances, whereas hormone replacement therapy is considered for HH. The patient’s progress and response to treatment are under careful monitoring.

Conclusion:
This case highlights the need for further research and comprehensive diagnostic evaluation to better understand the association between Fanconi syndrome and HH, emphasizing the importance of early diagnosis and management to prevent long-term complications.
Health inequities in the modulator era
Authors: Palla John B. , Laguna Theresa A. 
Published: August 2023

Purpose of review
To discuss the existing health inequities in people with cystic fibrosis (CF) and how the recent development of cystic fibrosis transmembrane regulator (CFTR) modulators may impact these inequities.

Recent findings
People with CF (pwCF) from low socioeconomic status (SES) have more pulmonary exacerbations, worse nutritional status, lower pulmonary function, and an increased mortality rate with less access to lung transplantation. pwCF who identify as racial and ethnic minorities have earlier mortality, lower lung function, are less likely to be detected on newborn screening resulting in a delayed diagnosis, are underrepresented in clinic trials, and less likely to be eligible for a CFTR modulator. Female sex is associated with more pulmonary exacerbations and earlier mortality. Sexual gender minorities are a vulnerable population with worse health outcomes, and more research is needed in CF. CFTR modulators are inaccessible to low to middle-income countries due to significant cost burden.

Summary
People with CF from low SES, racial and ethnic minorities, female sex, and sexual gender minorities face health inequities. CFTR modulator use will further widen existing health inequities given the unequal access to modulators based on nonqualifying genetics and exorbitant cost restricting use both on an individual and global level.