Medicine and Health Sciences Commons^™

Understanding Decision Making As It Influences Treatment In Thoracolumbar Burst Fractures Without Neurological Deficit: Conceptual Framework And Methodology, Charlotte Dandurand, Cumhur F. Öner, Olesja Hazenbiller, Richard J. Bransford, Klaus Schnake, Alexander R. Vaccaro, Lorin M. Benneker, Emiliano Vialle, Gregory D. Schroeder, Shanmuganathan Rajasekaran, Mohammad El-Skarkawi, Rishi M. Kanna, Mohamed Aly, Martin Holas, Jose A. Canseco, Sander Muijs, Eugen Cezar Popescu, Jin Wee Tee, Gaston Camino-Willhuber, Andrei Fernandes Joaquim, Ory Keynan, Harvinder Singh Chhabra, Sebastian Bigdon, Ulrich Spiegel, Marcel F. Dvorak

Rothman Institute Faculty Papers

STUDY DESIGN: This paper presents a description of a conceptual framework and methodology that is applicable to the manuscripts that comprise this focus issue.

OBJECTIVES: Our goal is to present a conceptual framework which is relied upon to better understand the processes through which surgeons make therapeutic decisions around how to treat thoracolumbar burst fractures (TL) fractures.

METHODS: We will describe the methodology used in the AO Spine TL A3/4 Study prospective observational study and how the radiographs collected for this study were utilized to study the relationships between various variables that factor into surgeon decision making.

RESULTS: With 22 …

Using Of Fragment Specific Plate 2.5 Millimetre In Cases Of Distal Radius Fracture, Ibrahim Ahmed Hussien, Amro Ahmed Fouaad, Ahmed Samy Al-Noamany

Al-Azhar International Medical Journal

Background: Fractures of the distal radius inside the joint are a common injury. Whether caused by high-energy trauma or, more commonly among the elderly and those with osteoporosis, low-energy trauma, these fractures tend to be unstable and require immediate medical attention. The use of external fixators for intra-articular distal radius fractures has been supplanted by the use of internal fixators. Aim and objectives: to examine the radiological and clinical results of treating distal radius fractures that occurred on the dorsum of the individual's right and left arms (dorsal or dorso-radial) using a fragment-specific plate (2.5 mm). Subjects and methods: Hospitals …

Endoscopic Assisted Management Of Benign Osteolytic Bone Lesions, Ahmed Mohamed Shawky, Mahmoud Seddik Hassan, Amro Ahmed Fouaad Attia, Ahmed Ismail Hammouda

Al-Azhar International Medical Journal

Background: Benign lytic bone lesions have various clinical and histopathological forms, the most frequent lytic lesions are unicameral bone cyst, giant cell tumor, aneurysmal bone cyst, fibrous dysplasia, osteoblastoma and enchondroma, and they are rarely to be symptomatic and usually diagnosed accidentally on imaging. Treatment has wide range from conservative treatment with regular follow up to many surgical interventions without significant established consensus to support any of them. Aim of the work: this study evaluates the outcome of endoscopic assisted management of benign osteolytic bone lesions for 2 year of follow up. Patients and methods: In this prospective, 20 patients …

Postoperative Discharge Destination Impacts 30-Day Outcomes: A National Surgical Quality Improvement Program Multi-Specialty Surgical Cohort Analysis, Carlos Riveros, Sanjana Ranganathan, Yash Shah, Emily Huang, Jiaqiong Xu, Michael Geng, Zachary Melchiode, Siqi Hu, Brian Miles, Nestor Esnaola, Dharam Kaushik, Angela Jerath, Christopher Wallis, Raj Satkunasivam

Student Papers, Posters & Projects

Surgical patients can be discharged to a variety of facilities which vary widely in intensity of care. Postoperative readmissions have been found to be more strongly associated with post-discharge events than pre-discharge complications, indicating the importance of discharge destination. We sought to evaluate the association between discharge destination and 30-day outcomes. A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients were dichotomized based on discharge destination: home versus non-home. The main outcome of interest was 30-day unplanned readmission. The secondary outcomes included post-discharge pulmonary, infectious, thromboembolic, and bleeding complications, …

Venous Thromboembolism In Orthopedic Surgery: Global Guidelines, Kadir Uzel, İbrahim Azboy, Javad Parvizi

Rothman Institute Faculty Papers

Venous thromboembolism (VTE) is a severe complication that can occur after major orthopedic procedures. As VTE-related morbidity and mortality are a significant concern for both medical professionals and patients, and preventative measures are typically employed. Multiple organizations, including the American College of Chest Physicians (ACCP) and the American Academy of Orthopedic Surgeons (AAOS), have developed guidelines for VTE prophylaxis specifically in patients undergoing joint replacement procedures. However, recently, the International Consensus Meeting (ICM) was convened, which brought together over 600 experts from 68 countries and 135 international societies. These experts, spanning a range of medical disciplines including orthopedic surgery, anesthesia, …

Does Physical Therapy Impact Clinical Outcomes After Lumbar Decompression Surgery?, Jeremy C. Heard, Nicholas D. D'Antonio, Mark J. Lambrechts, Payton Boere, Tariq Z. Issa, Yunsoo A. Lee, Jose A. Canseco, Ian David Kaye, Barrett R. Woods, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Rothman Institute Faculty Papers

OBJECTIVES: The objectives of our study were to (1) determine if physical therapy (PT) impacts patient-reported outcomes (PROMs) after lumbar decompression surgery and (2) determine if PT impacts postsurgical readmissions or reoperations after lumbar decompression surgery.

METHODS: Patients >18 years of age who underwent primary one‑ or two‑level lumbar decompression at our institution were identified. Patient demographics, surgical characteristics, surgical outcomes (all‑cause 90 days readmissions and 90 days surgical readmissions), and patient‑reported outcomes (PROMs) were compared between the groups. Multivariate linear regression was utilized to determine the individual predictors of 90 days readmissions and PROMs at the 1‑year postoperative point. …

State Of The Art Bowel Management For Pediatric Colorectal Problems: Hirschsprung Disease., Elizaveta Bokova, Ninad Prasade, Sanjana Janumpally, John Rosen, Irene Isabel P. Lim, Marc A. Levitt, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

After an initial pull-though, patients with Hirschsprung disease (HD) can present with obstructive symptoms, Hirschsprung-associated enterocolitis (HAEC), failure to thrive, or fecal soiling. This current review focuses on algorithms for evaluation and treatment in children with HD as a part of a manuscript series on updates in bowel management. In constipated patients, anatomic causes of obstruction should be excluded. Once anatomy is confirmed to be normal, laxatives, fiber, osmotic laxatives, or mechanical management can be utilized. Botulinum toxin injections are performed in all patients with HD before age five because of the nonrelaxing sphincters that they learn to overcome with …

Editorial: Intervertebral Disc Degeneration And Osteoarthritis: Mechanisms Of Disease And Functional Repair., Graciosa Q Teixeira, Jana Riegger, Raquel M Gonçalves, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

No abstract provided.

Secondary Analysis Of A James Lind Alliance Priority Setting Partnership To Facilitate Knowledge Translation In Degenerative Cervical Myelopathy (Dcm): Insights From Ao Spine Recode-Dcm, Benjamin Davies, Jamie Brannigan, Oliver D. Mowforth, Danyal Khan, Angus G.K. Mcnair, Lindsay Tetreault, Iwan Sadler, Ellen Sarewitz, Bizhan Aarabi, Brian Kwon, Toto Gronlund, Vafa Rahimi-Movaghar, Carl Moritz Zipser, Peter John Hutchinson, Shekar Kurpad, James S. Harrop, Jefferson R. Wilson, James D. Guest, Michael G. Fehlings, Mark R.N. Kotter

Department of Neurosurgery Faculty Papers

OBJECTIVES: To explore whether a James Lind Alliance Priority Setting Partnership could provide insights on knowledge translation within the field of degenerative cervical myelopathy (DCM).

DESIGN: Secondary analysis of a James Lind Alliance Priority Setting Partnership process for DCM.

PARTICIPANTS AND SETTING: DCM stake holders, including spinal surgeons, people with myelopathy and other healthcare professionals, were surveyed internationally. Research suggestions submitted by stakeholders but considered answered were identified. Sampling characteristics of respondents were compared with the overall cohort to identify subgroups underserved by current knowledge translation.

RESULTS: The survey was completed by 423 individuals from 68 different countries. A total …

State Of The Art Bowel Management For Pediatric Colorectal Problems: Functional Constipation., Elizaveta Bokova, Wendy Jo Svetanoff, John Rosen, Marc A. Levitt, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Functional constipation (FC) affects up to 32% of the pediatric population, and some of these patients are referred to pediatric surgery units to manage their constipation and/or fecal incontinence. The aim of the current paper is to report the recent updates on the evaluation and management of children with FC as a part of a manuscript series on bowel management in patients with anorectal malformations, Hirschsprung disease, spinal anomalies, and FC.

METHODS: A literature search was performed using Medline/PubMed, Google Scholar, Cochrane, and EMBASE databases and focusing on the manuscripts published within the last 5-10 years.

RESULTS: The first …

Management Of Pelvic Pain Caused By Endometriosis, Denisa Oana Balalau, Ioana Andreea Ciupitu, Delia-Maria Bogheanu, Alexia-Ioana Ghiocel-Zariosu, Cristian Balalau, Liana Ples, Daniela Gabriela Bălan, Ioana Paunica, Marina-Romina Sima

Journal of Mind and Medical Sciences

Endometriosis is a disorder of the epithelium and/or endometrial-like stroma outside the endometrium and myometrium, usually with an associated inflammatory process. It mainly affects young women of reproductive age, the prevalence being estimated at approximately 10%. Due to the varied clinical symptoms marked by chronic pelvic pain, dysmenorrhea, infertility, dyspareunia, dysuria, endometriosis requires a complex treatment. Endometriosis is a major health problem with socioeconomic impact, which is why many gynecological societies have published different guidelines to assist clinicians in the diagnosis and treatment of endometriosis. The variety of available treatments combined with the complexity of this disease leads to significant …

Lived Experience-Centred Word Clouds May Improve Research Uncertainty Gathering In Priority Setting Partnerships, Oliver D. Mowforth, Lance Burn, Danyal Z. Khan, Xiaoyu Yang, Sybil R.L. Stacpoole, Toto Gronlund, Lindsay Tetreault, Sukhvinder Kalsi-Ryan, Michelle L. Starkey, Iwan Sadler, Ellen Sarewitz, Delphine Houlton, Julia Carter, Paige Howard, Vafa Rahimi-Movaghar, James D. Guest, Bizhan Aarabi, Brian K. Kwon, Shekar N. Kurpad, James Harrop, Jefferson R. Wilson, Robert Grossman, Emma K. Smith, Angus Mcnair, Michael G. Fehlings, Mark R.N. Kotter, Benjamin M. Davies

Department of Neurosurgery Faculty Papers

INTRODUCTION: AO Spine RECODE-DCM was a multi-stakeholder priority setting partnership (PSP) to define the top ten research priorities for degenerative cervical myelopathy (DCM). Priorities were generated and iteratively refined using a series of surveys administered to surgeons, other healthcare professionals (oHCP) and people with DCM (PwDCM). The aim of this work was to utilise word clouds to enable the perspectives of people with the condition to be heard earlier in the PSP process than is traditionally the case. The objective was to evaluate the added value of word clouds in the process of defining research uncertainties in National Institute for …

Efficacy Of Repetitive Transcranial Magnetic Stimulation On Spasticity In Egyptian Multiple Sclerosis Patients, Abdelrahman M. Khattab, Mahmoud M. Abd Elsayed Saleh, Ahmed E. Sarhan

Al-Azhar International Medical Journal

Background; One of the most common neurologic disorders is multiple sclerosis. To improve quality of life, many tools have been employed. Repetitive transcranial magnetic stimulation (rTMS) is a new established technique to treat spasticity and improve the outcome of rehabilitation program in various neurologic conditions. Aim and objectives; To assess the effect of high frequency rTMS on improving spasticity in a sample of Egyptian MS patients. Patients and methods; 40 patients were recruited from the MS unit at Al-Azhar University hospitals with established diagnosis of MS and spasticity. Recruitment started from beginning of Jan, 2022 for 6 months. Patients were …

A Comparison Study Between Transosseous Pull Out And Anchors In Gamekeeper’S Injury, Mohamed Mohamed Bissar, Hassan Mahmoud Baraka, Amro Ahmed Fouaad, Ayman Shwky Morad

Al-Azhar International Medical Journal

Background: When the thumb's metacarpophalangeal (M.C.P.) joint has a ligamentous lesion, the joint becomes noticeably unstable, which is common. Aim: to assess the functional and clinical outcomes of two different reconstruction methods of the metacarpophalangeal joint (ulnar side) of the thumb (pullout suture & anchor) in unstable injuries. Subject and Methods: This was a prospective study of 30 cases admitted to Al-Azhar University Hospitals (El Hussein Hospital and Sayed Galal Hospital) with ligamentous injuries of the MCP joint (ulnar side) from August 2018 until February 2022. Results: Regarding outcome distribution among the studied patients, we found that 19 (63.3%) were …

Role Of Conventional And Pulsed Radiofrequency In Treatment Of Low Back Pain And Sciatica, Maamoun Mohammed Abo Shosha, Mohammed Ahmed Ellabbad, Mostafa Soliman Elmaghraby, Ahmed Maher Ahmed Ibrahim

Al-Azhar International Medical Journal

Background: Low back pain is a feeling of discomfort, stiffness, or muscle tension below the costal border in the upper part of the back of the thigh, above the lower gluteal folds. Sciatica can occur with low back pain. The two most common techniques are pulsed radiofrequency (PRF) and conventional radiofrequency (CRF). Both techniques employ heat produced by particle vibration to cause a lesion. PRF employs intermittent high-frequency current injection to diffuse heat into nearby tissues and prevent temperatures from rising beyond 42 °C, known as the neuronal injury threshold.

Aim of the study: To assess the efficacy of PRF …

The Relationship Between Esr/Crp Ratio, Platelet Indices And Rheumatoid Disease Activity, Omar Ashraf Mohamed Ibrahim, Mohamed Magdy Ghit, Ahmed Ali Assem, Hesham Salah Hamoud

Al-Azhar International Medical Journal

Background: Measurement of RA disease activity helps guide therapeutic decision and follow up. Several disease activity scores (DAS) have been developed. DAS28 is the most frequently utilized score and the backbone for the European League Against Rheumatism (EULAR) response criteria.

Objective: To evaluate the possible association between ESR/CRP ratio, MPV, and PDW and rheumatoid disease activity.

Subjects and methods: Ninety individuals were included and subdivided into three age and gender matched groups: Group A: 30 RA patients who received conventional DMARDS, Group B: 30 RA patients who received biological DMARDS, Group C: 30 healthy volunteers as a controls. Each participant …

Platelet Rich Plasma (Prp) Injection In The Treatment Of Supraspinatus Partial Tear, Ibrahim Hussien, Mohamed Gamal Kamel Abdelkader, Abdelrahman Mostafa Tawfik

Al-Azhar International Medical Journal

Background: Many people around the world suffer from rotator cuff (RC) lesions. RC tears are also extremely common complain, and their incidence rises with age. Both bursal-sided and articular-sided tears can occur as partial-thickness tears. Aim: We aimed to determine the role of therapeutic shoulder injection with platelet rich plasma (PRP) in the management of supraspinatus partial tears. Methods: This prospective research was performed on 20 patients at Al Azhar University Hospitals (El Hussein Hospital and Sayed Galal Hospital) from September 2021 to November 2022. We included twenty patients suffering from a partial-thickness tendon tear. We measured patient satisfaction after …

Comparative Study Between Percutaneous Elongation And Z- Lengthening Of Tight Achilles Tendon In Idiopathic Toe Walking Children, Eissa Ragheb Refaie, Mohamed Adel Abdelhamid Ibrahim, Mohamed Shawky Abdelsamie

Al-Azhar International Medical Journal

Background: Idiopathic toe-walking is a gait pattern in which the child walks on the balls of their feet or their toes without touch of the heel to the ground, in the absence of known medical conditions as neuromuscular problems.

Objective: To compare between the two surgical methods for lengthening of Achilles tendon in idiopathic toe walking children with tight heel cord, regarding technique of the operation, post-operative complication rates, functional results and advantages of one technique over the other. Materials and Methods: A prospective study was done in the Hospitals of Al-Azhar University (Bab El Shaerrya, and Al-Hussein Hospitals), between …

Anterior Cervical Discectomy And Fusion Using Cages Versus Cages And Plating, Hamdy Mohamed Behiry, Mansour Ali Hendawy, Mahmoud Mohammed Bayoumi

Al-Azhar International Medical Journal

Background: The anterior column receives rapid load bearing support, the disc space height is restored, foraminal decompression occurs, and interbody fusion is facilitated by cervical intervertebral disc replacement with cage. Aim: Aim of work was to assess the interbody fusion rate and to assess incidence of complications of 20 consecutive patients for degenerative one or more level anterior cervical disc utilizing cage/s versus cage/s and plate. Patients and Methods: A comparative research of 20 patients with degenerated cervical discs managed by an anterior cervical discectomy procedure and fusion (ACDF) using either cage alone (ACDF-CA) or cage and anterior plating (ACDF-CPC). …

Retrospective Analysis Of Risk Factors And Management Of Infection After Lumbar Spine Implantation, Hussien Mohamed Mohamed, Hussein Abo El-Gheit, Mohamed Abulsoud

Al-Azhar International Medical Journal

Background: Wound infection still has a negative impact on patient outcomes after spine surgery, despite the discovery of preventative medicines as well as improvements in surgical approach and postoperative care. The risk of intraoperative/postoperative infection is increased by utilizing a posterior surgical approach, applying instrumentation, using an allograft, requiring a blood transfusion, and longer operations.

Aim of the study: To determine the prevalence and risk factors for post-operative instrumental lumbar spinal infection and evaluate functional outcomes after the management of the infections.

Patients and Methods: This study was conducted on diseased persons whom had an infection after lumbar spine instrumentation …

Cages Alone Versus Plate Fixation With Cages After Four Levels Anterior Cervical Discectomy, Karim Mohamed Mohamed Elshafei, Ibrahim Gamel Ewaiss, Taha Mohamed Adel Fawi, Hamdi Nabawi Mostafa

Al-Azhar International Medical Journal

Purpose: This study assessed clinical and radiological outcomes to support the surgical decision of ACDF using cages alone versus cage-with-plate fixation in patients with four-level spondylotic myelopathy of the cervical spine.

Methods: This study enrolled 30 patients with four levels of cervical spondylotic myelopathy. The C Group (n=15) was subjected to ACDF using four cages, and the C&P Group (n=15) had additional plate fixation. They were followed up clinically and radiologically for at least 12 months. Scheduled for surgical intervention in the neurosurgery department of Misr University and hospitals of Al Azhar University and Nasr Institute from October 2020 to …

Comparative Study Between Iliac Bone Grafting Verses Latarjet Procedure For Surgical Management Of Anterior Shoulder Instability With Glenoid Bone Defect, Ibrahim Ahmed Hussine, Emad Mohamed Zayid, Mahmoud Salah Tork

Al-Azhar International Medical Journal

Background and Aim: Anatomical glenoid restoration by iliac graft transplant versus latarjet surgery is competing as a management option for recurrent traumatic anterior dislocation of the shoulder associated with glenoid bone loss. All patients, who have recurrent traumatic anterior dislocation of the shoulder with loss of glenoid bone rime, will be assessed effectively for their responses to the Latarjet or the Iliac Graft Transfer. Patients and Methods: There were 40 patients presented with Anterior dislocation of the shoulder who had open Latarjet operation or ICBGT operation in this prospective random research. Rowe and ASES ratings, satisfaction level, evaluation of range …

Ultrasound-Guided Injection Of Platelet-Rich Plasma Versus Dextrose 5% In Chronic Achilles Tendinopathy: Comparitive Study, Adnan Abdelaleem Elsebaiy, Ahmed Mohamed Abdelghaffar Zidan, Gamal Attia El-Sawy, Adel Wagdi Abd-Elwahab

Al-Azhar International Medical Journal

Background: A persistent musculoskeletal condition called achilles tendinopathy in which frequently affects the tendon's insertion.

Aim and objectives: Comparing effectiveness and safety of high-resolution ultrasound-guided platelet-rich plasma injection versus 5% dextrose in the treatment of chronic Achilles tendinopathy.

Subjects and methods: Blinded randomized controlled trial, whereas 30 of diseased persons with chronic heel pain shared and equally distributed to double collections, each collection includes 15 of patients and Each of them is injected with dextrose 5% Or platelet rich plasma with evaluation of the pain.

Results: In group 1, the mean pain score after operation (VAS) (before) was 8.1 ± …

Anticancer Effect Of Illicium Verum (Star Anise Fruit) Against Human Breast Cancer Mcf-7 Cell Line, Asra Khan Pahore, Shagufta Khan, Nasim Karim

Department of Biological & Biomedical Sciences

Objective: To investigate the anticancer effect of Illicium verum against human breast cancer MCF-7 cell line.
Methods: An experimental study was conducted in Multidisciplinary and Tissue Culture Laboratory, Aga Khan University in collaboration with Pharmacology Department of Bahria University Medical and Dental College, Karachi, Pakistan from January 2021 to June 2021. MCF-7 cells of Luminal-A breast cancer were seeded in 96-well plate and treated with I.verum methanol extract. After incubation, MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) dye was used for cell viability and cell proliferation assays to determine the number of dead and viable cells, and the absorbance was measured using an enzyme-linked …

Comparative Study Between Clinical Outcomes Of All Inside Technique And Standard Antero-Medial Technique In Anterior Cruciate Ligament Reconstruction, Abd Elkakim Farrag, Mohamed Alhalawany, Mahmoud Hamada

Al-Azhar International Medical Journal

Background: Although theoretically superior to traditional technique, anatomical single bundle ACLR via all-inside technique does not appear to demonstrate statistically significant advantages over conventional technique, as with the Lysholm scoring system. Aim of the work: This study compared the post-operative clinical outcomes of arthroscopic ACL restoration using the "all-inside approach" versus the "traditional procedure". Patients and Methods: Between March 2020 and December 2021, fifty patients were admitted to the department of Orthopedic surgery and Traumatology in Sayed Galal University Hospital with torn ACL exhibiting high grade pivot shift (II or III) under anesthesia. Results: The mean age of the patients …

A Long-Term Follow-Up Of The Stability Study: Multicenter Rct Comparing Anterior Cruciate Ligament Reconstruction With And Without Lateral Extra-Articular Tenodesis In Individuals At High Risk Of Graft Failure, Katelyn M. Inch

Electronic Thesis and Dissertation Repository

One hundred and ninety-six patients at the Fowler Kennedy Sport Medicine Clinic (FKSMC) undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) were randomized as part of the multi-center STABILITY study to receive either an isolated ACLR or ACLR with a lateral extra-articular tenodesis (LET). The STABILITY study followed these patients up to two years postoperative, and a long-term follow-up protocol was initiated afterwards. Eighty-two patients from this center were seen at three, five and seven years postoperative as part of a long-term follow-up. Our primary outcome was a composite outcome of instability and graft failure. Secondary outcomes included patient-reported outcome measures …

Total Hip Arthroplasty In Young Patients, Aaron G. Chen

Electronic Thesis and Dissertation Repository

Total hip arthroplasty (THA) is the gold standard in treatment of hip arthritis yet is often avoided in young patients due to concerns of inferior survivorship. We aim to explore the role of THA in young patients and assess whether these historical concerns are valid in contemporary THA by presenting the results of: (1) a systematic review and meta-analysis of the current literature, (2) a retrospective database review, and (3) a retrospective population-based study. We found excellent long-term survivorship with modern THA in young patients, demonstrating greater than 90% revision-free survival up to 15 years. Factors that may increase risk …

Treatment Modalities Of Complex Regional Pain Syndrome After Hand Surgery A Systematic Review And Meta-Analysis Study, Ali Mahmoud, Fawzy Hamza, Tarek Zayid

Al-Azhar International Medical Journal

ABSTRACTBackground: complex regional pain syndrome is a complex medical condition. Physical/occupational treatments, psychiatric counseling, neuropathic pain medicines, anti-inflammatories, and surgical intervention are utilized to treat complex regional pain syndrome (CRPS).Methods: systematic review and meta-analysis study of complex regional pain syndrome treatment modalities after hand surgeries in most recent literature. This research was conducted and reported following PRISMA (for systematic review and meta-analysis recommended reporting items). From 2016 to 2021.Results: 10 studies showed Responders with a high event in bisphosphonate than in Ketamine study with highly significant heterogeneity among included studies p-value 0.0005. 12 studies were included 6 studies showed adverse …

Role Of Overnight Pulse Oximetry In Diagnosis Of Obstructive Sleep Apnea Syndrome, Ahmed Gamal Eldin, Abd El-Hay Abd El-Hay, Ibrahim Yousef

Al-Azhar International Medical Journal

Background: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a serious public health concern in terms of incidence. Despite being the golden measure for determining the quality of sleep and detecting sleep disrupted breathing, polysomnography (PSG) is costly, consuming time, labor-intensive, less widely accessible, needs continuous observation and skill for the interpretation. Objective: To evaluate the sensitivity and specificity of overnight pulse oximetry (OPO) as a technique for detecting OSAHS. Patients and Methods: This cross-sectional research was done at Bab El-Shaaria University Hospitals in Cairo. In total, fifty persons were included in this research: forty patients were suffering from the manifestations …

A Comparative Evaluation Of Intra-Articular Injections Of Hyaluronic Acid, Adipose Mesenchymal Stromal Cells, Platelet-Rich Plasma And Corticosteroids In Patients With Knee Osteoarthritis., Younis Akl, Mohammed Elnahas, Shehab Mohamed Kamel

Al-Azhar International Medical Journal

*Background: Estimation of the clinical effects of platelet-rich plasma (PRP), steroids, hyaluronic acid (HA), or adipose mesenchymal stromal cells (MSC) injections in the treatment of knee osteoarthritis (OA). *Methods: From 2003 to 2021, researchers used Google Scholar, PubMed, Web of Science, Cochrane library, and other databases for randomized control trials (RCTs) with knee osteoarthritis that compared steroids, HA, adipose MSC, PRP, or in a head-to-head combination. *Results: There were a total of 24 trials in this study. Steroids are listed as the most useful intervention for pain or function management, whereas multiple PRP and adipose MSC were considered as the …