Medicine and Health Sciences Commons^™

Shockwave Therapy Versus Therapeutic Ultrasound And Kinesio Tape In Lateral Epicondylitis, Marwa Youssef Elsabry, Sobhiea Ali Mahmoud, Amira Shahin Ibrahim

Al-Azhar International Medical Journal

Background: Lateral epicondylitis is a degenerative injury that cannot be diagnosed by blood tests and rarely by X-rays; rather, it is usually diagnosed by the description of the site of the pain and by certain findings from a physical examination.

Aim of the work: To examine the respective contributions of shockwave therapy, therapeutic ultrasound, and Kinesio tape in managing lateral epicondylitis.

Methodology: This research was carried out at Al-Zahraa University Hospital and AL-Matria Teaching Hospital (Rheumatology & Rehabilitation department) on 90 patients were divided into three equal groups: Group I received ESWT, Group II applied kinesio tape, and Group III …

Arthroscopic Supra Pectoral Biceps Brachii Tenodesis (Revisited), Gamal Ahmed Mohamed, Ismail Hamouda, Emad Zayed

Al-Azhar International Medical Journal

Background: Tendinopathy of the long head of the biceps brachii (LHB), which is often caused by trauma, microinstability, increased activity, or an underlying inflammatory disease, is a common cause of anterior shoulder pain. Biceps tendon injuries are further complicated by the presence of pulley system lesions and associated risk factors, including a prior rotator cuff tear history and insufficient training.

Objectives: This study aimed to evaluate the short-term functional outcomes of patients who underwent arthroscopic suprapectoral biceps tenodesis for symptomatic biceps tendinopathy, focusing on a technique that avoids complications associated with open tenodesis surgery.

Methods: A prospective cohort study involved …

Arthroscopic Osteo-Chondral Auto-Graft Transplantation For Focal Cartilage Defect Of The Medial Condyle Of The Femur, Emad Zayed, Mohamed Ibrahim Abulsoud, Maysra Bayoumy

Al-Azhar International Medical Journal

Purpose: To evaluate the efficacy and outcomes (functional and radiological) of arthroscopic Osteo-chondral Auto-graft Transplantation (OAT) for focal cartilage defects of medial condyle of the femur.

Method: Twenty patients, Seventeen males (85%) and three females (15%), with a mean age of (24.95±6.6) and mean body mass index (BMI) (24.6±2.46) and a full-thickness chondral lesion of the articulating weight bearing surface of the medial femoral condyle, were treated by (OAT) from non-weight bearing region of the lateral femoral condyle. Our patients were evaluated using Lysholm score pre-and postoperatively. Post-operative and pre-operative plain radiographs of the affected knee and knee MRI were …

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 …

Assessment Of Spine Med® Traction Effect On Cervical Disc Herniation: Correlation Between Mri And Odi/Vas Score: A Randomized Study, Mohamed Mohamed Shahin, Abd-Elhamid Abdel-Hareth Ghazaly, Abd El-Shafy Ahmed Hasseb, Basem Mohamed Gomaa

Al-Azhar International Medical Journal

Background: Traction, as one of the earliest physical treatment methods, was utilized in the therapeutic approach to address disc herniation in both the cervical and lumbar spine. The work aimed to evaluate the impact of Spine MED® traction on symptoms and Magnetic imaging resonance (MRI) outcomes of cervical disc herniation in patients with cervical pain. Methods: This prospective cohort randomised study was performed on 100 individuals with cervical pain lasting for at least 6 months and have cervical disc herniation diagnosed by MRI. The participants were divided randomly into two equal groups: Group A, which served as the control group …

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 …

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 …

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). …

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 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 …

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 …

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 …

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 …

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 ± …

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 …

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 …

Surgical Management Of Cervical Myelopathy Anterior Versus Posterior Approaches, Abou Soud Mahmoud, Abdulkafy Sharafuddin, Usama El-Shokhaiby

Al-Azhar International Medical Journal

Background: The most prevalent cause of spinal cord impairment is cervical spondylotic myelopathy (CSM). In the older, it is also the primary cause of spinal-cord-related impairment. Spinal cord compression can result from ventral pathologies or from dorsal compression causing progressive disability and impairing the quality of life. Aim of study: This study aims to compare anterior cervical discectomy and fusion using inter body fusion cages with posterior lamin ectomy in the management of one or multiple level cervical spon dylotic myelopathy Patients and methods: 20 patients had cervical spondylotic myelo pathy were identified in our research. There were 16 men …

Joint Degeneration Cycle: A Novel Educational Model With Degenerative Intervertebral Disc Disease As An Example, Ahmed El-Sherif

Al-Azhar International Medical Journal

A four-stations educational model is presented for understanding degenerative joint disorders. Using this model in patient education is supposed to bring maximum benefit from all treatment modalities. It could also be used in medical education to alert physicians to the importance of interventions targeting all the stations of the cycle. Joint stability is an important part of its function. It depends on the joint integrity, surrounding ligaments, and muscles. The imbalance between the forces involved in the joint function will accelerate its degeneration. The degenerative process involves anatomical arthropathic changes that usually aim at restoring joint stability. These arthropathic changes …

Treatment Of Fracture Base Of First Metacarpel Bone (Bennet's Fracture) By Percutanous Locked Kirschner Wires Technique, Mohammed Shemes, Ehab Elzahed, Abd El-Hakim Abd Allaha

Al-Azhar International Medical Journal

Abstract Background Locked K-wire technique with connector has more advantages than others technique and immediately mobilization, so life-changing events that affect the patient's life Aim of the study: Assessment clinical and radiological outcomes of locked Kirschner-wire technique with an external connect to fixation of Bennett's fracture. Patients and Methods: A prospective study was conducted on twenty patients having Bennett's fracture during the period between July 2019 and June 2021, those who matched completely with inclusion criteria were included and followed up for 6 months. Results The mean age of all studied patients was 31.8 from 18-50 years .100% male. The …

Management Of Distal Tibial Fractures By Ilizarov Fixator With Or Without Minimal Internal Fixation, Moaaz Elgammal, Mostafa Elgahel, Ali Elgioshy

Al-Azhar International Medical Journal

Background: Ilizarov fixator has more advantages in some types of distal tibial fractures as open, type C3according to AO classification and give satisfactory results more than plates and screws fixation because it minimizes complications. The aim of the work: To estimate the techniques, results and complications of Ilizarov in management of distal tibial fractures with or without minimal internal fixation . Patient: During the period from August 2020 through June 2021, a prospective study was conducted on fifteen patients with fifteen tibial plafond fractures treated with Ilizarov fixator. The study consisted of 12 men and 3 women, with an average …

Evaluation Of Nailfold Capillaroscopy Pattern In Patients With Primary Osteoarthritis Of The Hands, Yasser Gazar, Sherif Ismail, Ahmed Fahmy

Al-Azhar International Medical Journal

Background: Hand osteoarthritis (OA) can be a distressing disorder that impairs a patients' quality of life. There is a relation between OA and vascular damage, especially atherosclerosis, and OA are both common chronic conditions associated with aging and obesity. Aim of the study: The objective of this research was to examine nailfold microcirculation in individuals with hand OA Patients and Methods: a cross-sectional, observational study, about 56 patients with hand OA were enrolled. All subjects underwent a standard radiology X-Ray examination of the hands and a Nailfold vascular examination was performed. Results: of the 56 patients studied were females, and …

Median Nerve Injury After Local Injection, Amro Attia

Al-Azhar International Medical Journal

Background, Iatrogenic median nerve injuries after local injection of carpal tunnel syndrome occur via direct injury. Complete or partial injury was observed. Surgeon should know the risk factors and how to prevent this case. Aim of the work. To overview the incidence, commonest drugs, our expertise in treating injection-related injuries, the functional recovery and how to prevent this injuries. Patient and methods. A retrospective analysis of management of 8 cases of injection-related iatrogenic median nerve injury from 2015 to 2020, Clinical presentation, neurological, and electrophysiological, were done. Failure of Conservative treatment is indicator for surgery, in the form of exploration, …

Evaluation Of Physiotherapy Impact On Rotator Cuff Shoulder Tendinopathy In Hypothyroid And Diabetic Patients, Hany Aly, Ashraf Aamer, Abdullah Gaafar, Mohamed Belih

Al-Azhar International Medical Journal

Background: Rotator cuff, acute or chronic tendonitis, is affected by diabetes and hypothyroidism. Physiotherapy plays a pivotal role in the outcome and improvement of rotator cuff tendinopathy. This cross-sectional study was conducted on forty patients with shoulder pain to study the impact of different physiotherapy modalities programs in both hypothyroid and diabetic rotator shoulder cuff tendinitis. Results: The mean of range of motion (ROM) among hypothyroid patients was 22.3±25.69 at first visit and increased to 77.7±65.02, whereas, the mean ROM among diabetic patients was 31.00 ±24.153 at first visit and increased to 101.55 ± 61.90. The ROM was of high …

Early Outcome Of Surgical Repair Of Complete Atrioventricular Canal Defects (Comparative Study Between Children Before And After 6 Months Of Age), Elhusseiny Gamil, Mohamed Sharaa, Bahaa El Khonizy, Ayman Khalifa

Al-Azhar International Medical Journal

Background: Complete atrioventricular septal defect (CAVSD) is composed of a primum atrial septal defect, nonrestrictive inlet ventricular septal defect and common atrioventricular (AV) valve. The aim of this study was to compare the result of surgical repair of complete atrioventricular (CAVC) before and after six months of age. Methods: Between January 2018 and December 2019 at Al-Azhar University and Atfal Misr hospital, 80 patients underwent CAVC repair. These patients were divided into 2 groups according to the age and each group is of 40 patients. These patients were managed by modified patch and double patch techniques. Results: In-group A, the …

Role Of Endoscopy In Osteolytic Bone Lesion Management, Amro Attia

Al-Azhar International Medical Journal

Abstract Background: Although benign bone tumors, osteomyelitis, and locally malignant tumors are potential to be locally aggressive. Various treatment approaches, such as aspiration and injection, en bloc resection, open curettage, and other methods like sclerotherapy, and embolization are described but the most appropriate treatment should be selected after considering the risk of tumor recurrence and treatment complications. Endoscopic curettage (ESC) may be a less invasive alternative to open curettage for benign bone tumors, locally malignant swelling and osteomyelitis with minimal complications and good function output. I will describe the use of ESC for the treatment of bone lesions and report …