Medicine and Health Sciences Commons^™

Unsupervised Machine Learning Using K-Means Identifies Radiomic Subgroups Of Pediatric Low-Grade Gliomas That Correlate With Key Molecular Markers, Debanjan Haldar, Anahita Fathi Kazerooni, Sherjeel Arif, Ariana Familiar, Rachel Madhogarhia, Nastaran Khalili, Sina Bagheri, Hannah Anderson, Ibraheem Salman Shaikh, Aria Mahtabfar, Meen Chul Kim, Wenxin Tu, Jefferey Ware, Arastoo Vossough, Christos Davatzikos, Phillip B Storm, Adam Resnick, Ali Nabavizadeh

Department of Neurosurgery Faculty Papers

Introduction: Despite advancements in molecular and histopathologic characterization of pediatric low-grade gliomas (pLGGs), there remains significant phenotypic heterogeneity among tumors with similar categorizations. We hypothesized that an unsupervised machine learning approach based on radiomic features may reveal distinct pLGG imaging subtypes.

Methods: Multi-parametric MR images (T1 pre- and post-contrast, T2, and T2 FLAIR) from 157 patients with pLGGs were collected and 881 quantitative radiomic features were extracted from tumorous region. Clustering was performed using K-means after applying principal component analysis (PCA) for feature dimensionality reduction. Molecular and demographic data was obtained from the PedCBioportal and compared between imaging subtypes.

Results: …

Prognostic Factors Of Myasthenia Gravis Remission After Thymectomy At National Referral Hospital In Indonesia, Suprayitno Wardoyo, Winda J. Layardi

The New Ropanasuri Journal of Surgery

Introduction. Thymectomy is a recommended treatment for myasthenia gravis, enfacing the problem of a low remission rate. However, Indonesian-specific characteristics of myasthenia gravis are somehow different from those of well-developed countries. Thus, identifying prognostic factors influencing remission is required for patient selection to provide optimal preoperative issues.

Methods. A retrospective cohort proceeded in our tertiary hospital, enrolling those diagnosed with myasthenia gravis who underwent thymectomy for four years. Disease period modified Osserman classification, age, sex, preoperative plasmapheresis, preoperative steroid therapy, type of surgery, and thymic pathology were the variables of interest for three-year follow-up. In addition, these variables …

Quality Of Life And Its Associated Factors In Patients After Esophagectomy At A Single National Referral Center, Dogma H. Sirirui, Agi S. Putranto

The New Ropanasuri Journal of Surgery

Introduction. Esophagectomy is the standard surgical treatment for resectable esophageal cancer patients. However, the success rate for this procedure was about 25–35% and was associated with a severe risk of postoperative complications. In addition, patients after esophagectomy have decreased their quality of life (QOL), but no research has been done in Indonesia. Therefore, this study was conducted to determine the quality of life after esophagectomy in Indonesia based on the patient population at Dr. Cipto Mangunkusumo General Hospital (CMGH).

Method. A retrospective study was conducted using quality–of–life instruments issued by the European Organization for Research and Treatment of Cancer (EORTC). …

Potential Of Tumor Cell Seeding And Clinical Impact On Percutaneous Breast Biopsy Tracks: A Literature Review, I G.N. Gunawan Wibisana, Muhammad Mirwan

The New Ropanasuri Journal of Surgery

Introduction. Based on its effectiveness, a percutaneous breast biopsy was chosen because it has minimum side effects and fewer complications, does not distort the breast tissue architecture, and can be performed on an outpatient basis. However, the biopsy can damage the integrity of tumor cells, creating seeding at the site of the track made. Therefore, core biopsy is the method of choice for breast lesion sampling using a 14G needle that provides greater sensitivity. This study aims to explain whether the percutaneous biopsy track has the potential for the formation of tumor cell seeding and its clinical impact.

Methods …

Prognostic Factors For Mortality Of Pediatric Burn Injury In A National Tertiary Referral Center, Heru Angkoso, Aria Kekalih

The New Ropanasuri Journal of Surgery

Introduction. In Indonesia, burn injuries cause about 195,000 deaths annually. Data from the Ministry of the Health Republic of Indonesia showed the incidence of burns predominated at 1-4 years old. The mortality of pediatric burn patients in a tertiary hospital was 37.26%. This study aimed to find an association between known and unknown prognostic factors of mortality in Indonesian-specific characteristics.

Method. A retrospective analytical study included all pediatric burns admitted to Dr. Cipto Mangunkusumo General Hospital (CMGH) from 1998 to 2010. Variables within a period of the first 72 hours of admission were the focus of interest and were extracted …

Comparison Ultrasound-Guided Handheld Vacuum Assisted Breast Biopsy And Core Biopsy In Breast Cancer, Anak Agung Ngurah Bagus Satya Sueningrat, Mendy Mendy

The New Ropanasuri Journal of Surgery

Introduction. Needle biopsy, including core needle biopsy (CNB) and vacuum-assisted breast biopsy (VABB) with or without radiological support) is the initial investigative method of choice for the preoperative diagnosis of breast lesions. Ultrasound-guided VABB (US-VABB) has become widely accepted because of its high accuracy. In this review, the diagnostic performance indices of CNB were compared with US-VABBB techniques.

Method. A literature search proceeded in online databases compiling studies from the last 20 years in the PubMed, EBSCOhost, ScienceDirect, and ProQuest databases. Eighteen eligible studies compared US-VABB and CNB for diagnostic accuracy. All studies were cohort retrospective. This literature search proceeded …

Transplantation In Pediatrics Liver Failure Associated With Acute Hepatitis Of Unknown Etiology, Afid B. Putra, Agi S. Putranto, Muftah Risyaldi, Luthfian A. Nurachman

The New Ropanasuri Journal of Surgery

Introduction. On 5^th April 2022, some cases of severe acute hepatitis of unknown etiology in children were reported in the United Kingdom. Since then, the number has increased rapidly, with 650 probable cases identified worldwide. This review focuses on available information about managing acute liver failure (ALF) in pediatrics with acute hepatitis of unknown etiology through the perspective of hepatobiliary surgery.

Method. A literature review proceeded on some databases, namely PubMed and Google Scholar. Epidemiological data and technical policy were obtained from World Health Organization and some government institutions.

Results. Severe acute hepatitis can progressively develop into acute liver …

The Correlation Between Premenopausal Estrogen And Estrogen Receptors In Breast Cancer, Ahmad Kurnia, Dedy Pratama, Muhammad Mirwan

The New Ropanasuri Journal of Surgery

Introduction. The correlation between the premenopausal estrogen hormone and estrogen receptors is unknown. The hormone estrogen has a risk factor for causing breast cancer. Meanwhile, the estrogen receptor plays a role in determining further treatment plans in breast cancer patients. Patients with high estrogen receptors have a better prognosis. If the premenopausal estrogen hormone can affect the estrogen-receptor, then the estrogen hormone can be modified to have a better prognosis.

Method. A cross-sectional study enrolled 32 subjects with complete data and was statistically analyzed to find the correlation between premenopausal estrogen hormone and estrogen-receptors.

Results. The estradiol ranged from 15.3 …

The Potential Of Liquid For Breast Cancer: A Review, Sonar Soni Panigoro, Clarissa Kezia Yuella -

The New Ropanasuri Journal of Surgery

Introduction. Tissue biopsy is the current gold standard for cancer diagnosis, targeted treatment, and prognosis. However, biopsy is an invasive procedure that could result in postoperative bleeding, pain, and infection. Such limitations may now be resolved by the clinical technique known as liquid biopsy, which enables a better representation of disease status.

Method. This literature review was conducted through online databases (PubMed, Ascopubs, EuroPMC) using the following keywords: "liquid biopsy", "ctDNA", "CTC", "breast cancer", "pathogenesis of breast cancer", "tumor microenvironment”, “ctdna detection technologies”, "early diagnosis", "targeted therapy" ,"monitoring disease progression”, and "prognosis”. The literature search was conducted using the PRISMA …

Surgical Intervention For Endobronchial Tuberculosis With Total Bronchial Occlusion: A Case Report, Muhammad A. Putra, Matthew Billy, Radhyaksa Ardaya, Rut Hp Ekasiwi, Sari Rahmawati, Karel Hs Sumarsudi

The New Ropanasuri Journal of Surgery

Introduction. Endobronchial Tuberculosis (EBTB) is a specific TB form affecting the tracheobronchial tree with microbial and histopathological evidence. Early diagnosis is essential to provide timely treatment and prevent complications but also proves difficult due to the low positive rate of acid–fast bacilli (AFB) staining of sputum smears and non–specific clinical and radiological findings.

Case Illustration. We reported a 19–year–old man with a productive cough suspected of pulmonary tuberculosis, with a positive GeneXpert test and negative AFB smear. He received anti–tuberculosis drugs for six months. Although the symptoms initially seemed to improve, the patient complained of dyspnea during moderate activities in …

Initial Single Surgeon Evaluation Comparing C-Arm Fluoroscopy With The Cirq Robotic Assistance Device For Instrumentation Of The Thoracolumbar Spine, Sohum K. Desai, Jennifer Adams

MEDI 9331 Scholarly Activities Clinical Years

Objective

To compare our experience with pedicle screw insertion of the thoracolumbar spine utilizing the Cirq robot assistance device compared with traditional paradigm using fluoroscopy.

Methods

We prospectively collected data of patients undergoing pedicle screw instrumentation in the thoracolumbar spine performed by a single surgeon at three different centers. One center took delivery of the Cirq robotic assistance device. Remaining two centers used C-arm fluoroscopy. Demographic information, diagnosis, total OR time, intraoperative complications, unexpected return to the operating room, and hospital readmissions within 90 days was compared between the two cohorts.

Results

A total of 166 screws were placed during …

Warren B. Davis And The Birth Of Plastic Surgery In Philadelphia: A Historical Vignette, Sarah F. Wagoner, Charles J. Yeo, Renee M. Tholey, James W. Fox, Steven E. Copit

Department of Surgery Faculty Papers

The field of plastic surgery, formally organized in 1931 with the founding of the American Society of Plastic and Reconstructive Surgery, was shaped in many ways by a small practice of Philadelphia physicians. At the center of the practice was Warren B. Davis, a Philadelphia otolaryngologist and plastics pioneer whose innovations in cleft palate surgery would lead to significant improvements in functional and cosmetic outcomes in his time. In addition to his own innovations, Davis was responsible for the training of John Reese, the inventor of the Reese dermatome that changed the face of burn medicine during World War II. …

Adjuvant Nab-Paclitaxel + Gemcitabine In Resected Pancreatic Ductal Adenocarcinoma: Results From A Randomized, Open-Label, Phase Iii Trial, Margaret A. Tempero, Uwe Pelzer, Eileen M. O'Reilly, Jordan Winter, Do-Youn Oh, Chung-Pin Li, Giampaolo Tortora, Heung-Moon Chang, Charles D. Lopez, Tanios Bekaii-Saab, Andrew H. Ko, Armando Santoro, Joon Oh Park, Marcus S. Noel, Giovanni Luca Frassineti, Yan-Shen Shan, Andrew Dean, Hanno Riess, Eric Van Cutsem, Jordan Berlin, Philip Philip, Malcolm Moore, David Goldstein, Josep Tabernero, Mingyu Li, Stefano Ferrara, Yvan Le Bruchec, George Zhang, Brian Lu, Andrew V. Biankin, Michele Reni

Department of Surgery Faculty Papers

PURPOSE

This randomized, open-label trial compared the efficacy and safety of adjuvant nab-paclitaxel + gemcitabine with those of gemcitabine for resected pancreatic ductal adenocarcinoma (ClinicalTrials.gov identifier: NCT01964430). METHODS

We assigned 866 treatment-naive patients with pancreatic ductal adenocarcinoma to nab-paclitaxel (125 mg/m2) + gemcitabine (1,000 mg/m2) or gemcitabine alone to one 30-40 infusion on days 1, 8, and 15 of six 28-day cycles. The primary end point was independently assessed disease-free survival (DFS). Additional end points included investigator-assessed DFS, overall survival (OS), and safety. RESULTS

Two hundred eighty-seven of 432 patients and 310 of 434 patients completed nab …

Development Of An On-Call Assessment Tool For Competency-Based Surgical Training, Eric C. Mitchell

Electronic Thesis and Dissertation Repository

Introduction: A central tenet of competency-based medical education is formative assessment of trainees. There are no assessments examining resident competence on-call, despite this being a significant component of resident training and characterized by less supervision compared to daytime.

Methods: A national survey was conducted to evaluate the state of assessment in Canadian Plastic and Reconstructive Surgery programs. An on-call assessment tool was developed based on a consensus group and was piloted over six months. Validity of the tool was examined through qualitative and quantitative methods.

Results: There were 63 tools completed across ten residents and seven staff physicians. Tool reliability …

Pyrvinium Pamoate: Past, Present, And Future As An Anti-Cancer Drug, Christopher W Schultz, Avinoam Nevler

Department of Surgery Faculty Papers

Pyrvinium, a lipophilic cation belonging to the cyanine dye family, has been used in the clinic as a safe and effective anthelminthic for over 70 years. Its structure, similar to some polyaminopyrimidines and mitochondrial-targeting peptoids, has been linked with mitochondrial localization and targeting. Over the past two decades, increasing evidence has emerged showing pyrvinium to be a strong anti-cancer molecule in various human cancers in vitro and in vivo. This efficacy against cancers has been attributed to diverse mechanisms of action, with the weight of evidence supporting the inhibition of mitochondrial function, the WNT pathway, and cancer stem cell renewal. …

Thoracic Aortic Aneurysm Patients’ Diagnosis, Treatments, And Outcomes: The New York Experience, Ashutosh Yaligar, Annet Kuruvilla, Joshua Helali, Junying Wang, Mohammad Noubani, Sohaib Agha, Daniel Wolbrom, Jie Yang, Jonathan Price, Thomas Bilfinger, Henry Tannous, Annie-Laurie Shroyer, Allison Mclarty

Department of Surgery Faculty Publications

IMPORTANCE: Traditionally, thoracic aortic aneurysms (TAA) were diagnosed upon complications arising or post-mortem examination. Following 2014, asymptomatic new TAA diagnoses noticeably rose at increasing rates. In parallel, reductions in the rates of urgent/emergent TAA-related treatments and adverse risk-adjusted short-term outcomes were observed.

OBJECTIVES: For New York State adult residents, the trends from 2005 to 2018 in new thoracic aortic aneurysm (TAA) diagnoses, surgical treatments, percutaneous treatments, and risk-adjusted outcomes were examined.

DESIGN: This retrospective cohort study documented the quality of TAA care provided to New York adult residents.

SETTING: Using the 2005 to 2018 New York Statewide Planning and …

Epigenetic Basis Of Diabetic Vasculopathy, Theja Bhamidipati, Manishekhar Kumar, Sumit S. Verma, Sedat Kacar, Diamond Reese, Michelle M. Martinez, Malgorzata M. Kamocka, Kenneth W. Dunn, Chandan K. Sen, Kanhaiya Singh

Einstein Health Papers

Type 2 diabetes mellitus (T2DM) causes peripheral vascular disease because of which several blood-borne factors, including vital nutrients fail to reach the affected tissue. Tissue epigenome is sensitive to chronic hyperglycemia and is known to cause pathogenesis of micro- and macrovascular complications. These vascular complications of T2DM may perpetuate the onset of organ dysfunction. The burden of diabetes is primarily because of a wide range of complications of which nonhealing diabetic ulcers represent a major component. Thus, it is imperative that current research help recognize more effective methods for the diagnosis and management of early vascular injuries. This review addresses …

Sagittal Alignment Differences On The Operating Room Table Compared To Preoperative And Postoperative Imaging In Anterior Cervical Discectomy And Fusion, Mark J. Lambrechts, Gregory R. Toci, Brian A. Karamian, Zachary Kozick, John Prodoeh, David Reiter, Rahul Muchintala, Eric Tecce, Alexander Vaccaro Jr., Patrick O’Connor, Amit Syal, Dominic Lambo, Jose A. Canseco, I. David Kay, Barrett I. Woods, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder

Rothman Institute Faculty Papers

Study Design: The study design used was a retrospective cohort. Objective: The objective of this study is to determine if intraoperative improvements in sagittal alignment on the operating table persisted on postoperative standing radiographs. Summary of Background Data: Cervical sagittal alignment may be correlated to postoperative outcomes. Since anterior cervical discectomy and fusions (ACDFs) can restore some cervical lordosis through intervertebral grafts/cages, it is important to understand if intraoperative radiographic measurements correlate with persistent postoperative radiographic changes. Materials and Methods: Patients undergoing elective primary ACDF were screened for the presence of lateral cervical radiographs preoperatively, intraoperatively, and postoperatively. Patients were …

The Importance Of Stigma Theory For Clinical Decisions Related To Diabetic Foot Amputations, Rachael Garcia, Callie Bartkowiak, Alison Nesbitt Do

Clinical Research in Practice: The Journal of Team Hippocrates

The authors examine the unconsidered impact of social stigma theory on the shared clinical decision-making process for a patient with foot osteomyelitis and MRSA bacteremia facing the prospect of an amputation.

Glucocentric Drugs In Cardiovascular Disease Protection And Heart Failure, Khawaja M. Talha, Gregg C. Fonarow, Salim S. Virani, Javed Butler

Office of the Provost

Evidence for cardiovascular outcomes with older-generation antihyperglycemic drugs in the management of type 2 diabetes is based on aggregated data from prior randomized controlled trials and observational studies that were not focused on prespecified cardiovascular end points. Newer antihyperglycemic medications have undergone a rigorous evaluation of cardiovascular outcomes through randomized controlled trials since the US Food and Drug Administration imposed a mandatory requirement for all glucose-lowering drugs in 2008. The three classes of drugs that have been most extensively studied are dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter-2 (SGLT2) inhibitors, the latter two reporting significant …

Safety And Efficacy Of Salvage Therapy With Laser Interstitial Thermal Therapy For Malignant Meningioma Refractory To Cesium-131 Brachytherapy: Illustrative Case, Clifford Yudkoff, Aria Mahtabfar, Keenan Piper, Kevin Judy

Department of Neurosurgery Faculty Papers

BACKGROUND

Anaplastic meningioma are rare, cancerous tumors of the central nervous system that often require multimodal therapy for tumor control. Both laser interstitial thermal therapy (LITT) and brachytherapy with implanted cesium-131 metallic seeds have demonstrated efficacy in the treatment of recurrent and resistant anaplastic meningioma; however, their safety as a dual therapy has never been reported.

OBSERVATIONS

In this report, the authors present a case of a 53-year-old female who received LITT in combination with brachytherapy after surgical and radiation treatment options had been exhausted. The authors discuss the unique safety concern of thermal injury with this treatment combination and …

Responsive Neurostimulation (Rns) Of The Centromedian Nucleus Of The Thalamus For The Treatment Of Drug Resistant Idiopathic Generalized Epilepsy, Angelique Manasseh, Hannah Guider, Brooklynn Bondy, Ayman Haykal, Nour Baki, Ashleigh Terrell, Michael Staudt, Christopher Parres, Andrew Zillgitt

Conference Presentation Abstracts

Rationale: Idiopathic generalized epilepsy (IGE) accounts for approximately one-third of all epilepsies. The majority of people with IGE achieve seizure-freedom from treatment with anti-seizure medications (ASM). However, up to 25% of people with IGE continue to experience seizures despite adequate ASM trials. In patients with drug resistant IGE, neuromodulation with responsive neurostimulation (RNS) in the bilateral centromedian nucleus (CMN) of the thalamus may be an effective treatment option. Methods: Five patients with drug resistant IGE were evaluated through the Beaumont Adult Comprehensive Epilepsy Center and underwent an epilepsy presurgical evaluation including video-EEG monitoring in the epilepsy monitoring unit, brain MRI, …

Impact Of The 2016 American College Of Surgeons Guideline Revision On Overlapping Lumbar Fusion Cases At A Large Academic Medical Center, Ali S. Farooqi, Austin J. Borja, Rashad Jabarkheel, Gregory Glauser, Krista Strouz, Scott Mcclintock, Neil R. Malhotra

Mathematics Faculty Publications

OBJECTIVE: The American College of Surgeons (ACS) u pdated its guidelines on overlapping surgery in 2016. The objective was to examine differences in postoperative outcomes after overlapping surgery either pre-ACS guide-line revision or post-guideline revision, in a coarsened exact matching sample. -METHODS: A total of 3327 consecutive adult patients u ndergoing single-level posterior lumbar fusion from 2013 to 2019 were retrospectively analyzed. Patients were separated into a pre-ACS guideline revision cohort (surgery before April 2016) or a post-guideline revision cohort (surgery after October 2016) for comparison. The primary outcomes were proportion of cases performed with any degree of overlap, and …

A Single Centre Experience Of Local Perforator Flaps In Oncoplastic Breast Surgery: A Cross-Sectional Study, Sana Zeeshan, Lubna Vohra, Uzma Shamsi, Nida Zahid, Danish Ali, Nargis Asad, Cristina Garusi

Section of General Surgery

Background & objectives: Various oncoplastic techniques have emerged over the years to preserve breast cosmesis and symmetry without compromising the principles of tumor excision. One of the newer techniques for breast volume replacement to achieve symmetry and cosmesis is the use of fasciocutaneous pedicled chest wall perforator flaps or local perforator flaps (LPF). The objectives of this study were to document the details of the surgical procedure as well as patient-reported satisfaction and well-being following the procedure using a validated BREAST-Q tool among Pakistani women.
Materials & methods: This cross-sectional study was conducted from March 2019 to February 2021 enrolling …

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 …

Perioperative Chanage In Cervical Lordosis And Health-Related Quality-Of-Life Outcomes, Jose A Canseco, Brian A Karamian, Parthik D Patel, Michael Markowitz, Joseph K Lee, Mark F Kurd, D Greg Anderson, Jeffrey A Rihn, Alan S Hilibrand, Christopher K Kepler, Alexander R Vaccaro, Gregory D Schroeder

Rothman Institute Faculty Papers

BACKGROUND: Surgeons have scrutinized spinal alignment and its impact on improving clinical outcomes following anterior cervical discectomy and fusion (ACDF). The primary analysis of this study examines the relationship between change in perioperative cervical lordosis (CL) and health-related quality-of-life (HRQOL) outcomes after ACDF. Secondary analysis evaluates the effects of fusion construct length on outcomes in patients grouped by preoperative cervical alignment.

METHODS: A retrospective cohort study was performed on an institutional database including patients who underwent 1- to 3-level ACDF. C2-C7 CL was measured preoperatively and at final follow-up. For primary analysis, patients were classified based on their perioperative cervical …

Histopathological Study About The Effects Of Chronic Concomitant Administration Of Both Pregabalin And Ibuprofen On The Skeletal, Cardiac And Smooth Muscles Of Male Albino Rats, Hytham Hemeida, Fouad El Dabbah, Nagy Alfadaly, Al-Sayed Tealeb

Al-Azhar International Medical Journal

Background: there is not enough information available to assess the relationship between Pregabalin use and muscular damage. Also, the effect of pregabalin ibuprofen combination on musculature not well assessed till now. Objectives: The study aimed to evaluate the possible chronic concomitant effect of both pregabalin and ibuprofen on skeletal, cardiac and smooth muscles in male albino rats. Subjects and methods: One hundred adult healthy male albino rats weighting 200 – 250 gm were obtained from the animal house, Faculty of Medicine, Assiut University, Egypt. The animals were classified into five groups: Group one (Negative control):10 male albino rats, received normal …

Intravenous Versus Intramuscular Oxytocin In The Prevention Of Atonic Post-Partum Hemorrhage After Vaginal Delivery, Taha Abd Elghany, Mofeed Mohamed, Muhamed Abdelmoaty

Al-Azhar International Medical Journal

Background: Primary postpartum hemorrhage (PPH) is among of the most main sources of mother deaths throughout the world. The changed profile of laboring women, who are now more probable to be aged, overweighted, or have substantial clinical co-morbidities, is leading to an increase in obstetric difficulties, Aim and objectives: in a double-blind controlled experiment, to examine the impact of an intramuscular (IM) single dose of oxytocin (10 IU per 1 mL) and placebo IV administration (1 mL 0.9 % saline gradually administered ) with an IV single dose of oxytocin (10 IU per 1 mL administered gradually over 1 min) …

The Role Of Repetitive Transcranial Magnetic Stimulation In Spastic Hemiplegic Cerebral Palsy In A Sample Of Egyptian Children, Ahmed Muhammad, Hossam Emam, Abdel-Ghaffar Fayed

Al-Azhar International Medical Journal

ABSTRACT Background; One of the most common neurologic disorders is cerebral palsy. To improve quality of life, many tools have been employed. 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 and motor performance in spastic hemiplegic CP in a sample of Egyptian children. Patients and methods; 65 children aged between 4-18 years attending the Neuro-Pediatric Unit of Al-Azhar University hospitals were recruited in the period from beginning of Jan, 2022 to the end of …

Mid-Secretory Uterine Artery Doppler Indices And Endometrial Thickness In Patients With Unexplained Recurrent Pregnancy Loss, Eshraq Mohammed, Ahmed Nasr, Wael Hamed

Al-Azhar International Medical Journal

Back ground : Recurrent pregnancy loss (RPL) occurs in up to 3% reproductive age couples. Potential uterine predictors for implantation measurable by ultrasound include endometrial thickness and volume, endometrial pattern, as well as blood flow in the uterine and sub-endometrial arteries. Aim: to evaluate endometrial thickness and uterine artery blood flow using Transvaginal color Doppler ultrasound during the midluteal phase of the menstrual cycle for women with unexplained recurrent pregnancy loss (RPL). Patients and methods: A prospective controlled clinical trial was conducted on 90 non pregnant women :45 Patient group and 45 Control group. All participants underwent comprehensive examinations and …