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methods to shorten the duration of an external fixator in the management of tibial infections

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World Journal of Orthopedics 2011年第9期2卷 85-92页

作者： khaled m emara khaled Abd Al Ghafar mohamed Ahmed Al Kersh Orthopaedic Surgery Ain Shams University HospitalsCairo 0020Egypt Lecturer in Orthopaedic Surgery Ain Shams UniversityCairo 0020Egypt Assistant Lecturer of Orthopaedic Surgery Ain Shams UniversityCairo 0020Egypt

massive segmental bone loss due to chronic osteomyelitis represents a considerable challenge to orthopedic surgeons and is a limb threatening *** only option available in such a clinical situation is segment transport using the Ilizarov technique of distraction osteogenesis;yet the most common problem in cases of bone transport with the Ilizarov technique in massive bone loss,is the long duration of the *** addition to autologous bone grafting,several mechanical,biologic,and external physical treatment modalities may be employed to promote bone formation and maturation during segment transport in osteomyelitis *** approaches include compressive loading of the distraction regenerate,increased frequency of small increments of distraction,and *** nailing and hemicorticotomy can reduce the time in external fixation;however,these techniques are associated with technical difficulties and *** application of low-intensity pulsed ultrasound or pulsed electromagnetic fields may shorten the duration of external *** promising modalities include diphosphonates,physician-directed use(off-label use)of bone morphogenetic proteins,and local injection of bone marrow aspirate and platelet gel at the osteotomy ***-designed clinical studies are needed to establish safe and effective guidelines for various modalities to enhance new bone formation during distraction osteogenesis after segment transfer.

关键词： Ilizarov Bone infection Intramedullary nail Hemicorticotomy Tibiofibular synostosis Fibular transport

mid-term results of sub-trochanteric valgus osteotomy for symptomatic late stages Legg-Calvé-Perthes disease

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World Journal of Orthopedics 2023年第5期14卷 328-339页

作者： khaled m emara Ramy Ahmed Diab Ahmed K emara mohamed Eissa mostafa Gemeah Shady Abdelghaffar mahmoud Department of Orthopedic Surgery Ain Shams UniversityCairo 11591Egypt Department of Orthopedic Surgery Cleveland Clinic FoundationClevelandOH 9500United States Health Care Innovation Program Arizona State UniversityTempeAZ 85287United States

BACKGROUND The treatment of late stages of Legg-Calvé-Perthes disease(LCPD)is *** the concept of femoral head containment is a well-established technique of treatment,its use remains debatable in the late stages of the disease,as it does not improve symptoms in terms of limb length discrepancy and *** To assess the results of subtrochanteric valgus osteotomy in symptomatic patients with late-stage Perthes *** From 2000 to 2007,36 symptomatic patients with late stage of Perthes disease were surgically treated with subtrochanteric valgus osteotomy and followed-up for 8 to 11 years using the IOWA score and range of motion(ROm)*** mose classification was also assessed at the last follow-up to reflect possible *** patients were 8 years old or older at the time of surgery,in the post-fragmentation stage,and complaining of pain,limited ROm,Trendelenburg gait,and/or abductor *** The preoperative IOWA score(average:53.3)markedly improved at the 1-year post follow-up period(average:85.41)and then slightly improved at the last follow-up(average:89.4)(P valuem improved,with internal rotation increased on average by 22°(from 10°preoperatively to 32°postoperatively)and abduction increased on average by 15.9°(from 25°preoperatively to 41°postoperatively).The mean mose deviation of femoral heads was 4.1 mm at the end of the follow-up *** tests used were the paired t-test and Pearson correlation test,where the level of significance was a P value less than *** Subtrochanteric valgus osteotomy can be a good option for symptomatic relief in patients with late-stage of LCPD.

关键词： Legg-Calvé-Perthes disease Femoral head avascular necrosis Valgus osteotomy Deformity correction Post fragmentation stage Late stage Perthes

Recent biological trends in management of fracture non-union

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World Journal of Orthopedics 2015年第8期6卷 623-628页

作者： khaled m emara Ramy Ahmed Diab Ahmed khaled emara Department of Orthopaedic Surgery Ain Shams University Faculty of medicine Ain Shams University

Bone regeneration is a complex, well-orchestrated physiological process of bone formation, which can be seen during normal fracture healing, and is involved in continuous remodelling throughout adult life. Currently,there is a plethora of different strategies to augment the impaired or "insufficient" bone-regeneration process, including the "gold standard" autologous bone graft, free fibula vascularised graft, allograft implantation, and use of growth factors, osteoconductive scaffolds, osteoprogenitor cells and distraction osteogenesis. Improved "local" strategies in terms of tissue engineering and gene therapy, or even "systemic" enhancement of bone repair, are under intense investigation, in an effort to overcome the limitations of the current methods, to produce bone-graft substitutes with biomechanical properties that are as identical to normal bone as possible, to accelerate the overall regeneration process, or even to address systemic conditions, such as skeletal disorders and osteoporosis. An improved understanding of the molecular and cellular events that occur during bone repair and remodeling has led to the development of biologic agents that can augment the biological microenvironment and enhance bone repair. Orthobiologics, including stem cells, osteoinductive growth factors, osteoconductive matrices, and anabolic agents, are available clinically for accelerating fracture repair and treatment of compromised bone repair situations like delayed unions and nonunions. A lack of standardized outcome measures for comparison of biologic agents in clinical fracture repair trials, frequent off-label use, and a limited understanding of the biological activity of these agents at the bone repair site have limited their efficacy in clinical applications.

关键词： Biological Fracture repair Nonunion Cell therapy Bone substitutes

Virtual orthopedic assessment:main principles and specific regions

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World Journal of Orthopedics 2021年第9期12卷 672-684页

作者： khaled m emara Ramy Ahmed Diab mohamed Amr Shady Abdelghaffar mahmoud mohamed Nour Ahmed Abdelsalam mahmoud Ahmed Elshobaky mona Farhan mostafa Gemeah Ahmed K emara Orthopedic Surgery Department Ain Shams UniversityCairo 11566Egypt Orthopedic Surgery Department Bank Ahly HospitalCairo 11566Egypt Department of Health Care Innovation Arizona State UniversityArizonaAZ 85287United States Department of Orthopedic Surgery Cleveland ClinicOhioNY 44195United States

Telemedicine was originally created as a way to treat patients who were located in remote places far away from local health facilities or in areas with shortages of medical *** is still used today to address those problems,and is increasingly becoming a tool for convenient medical *** the emergence of pandemics,telemedicine became almost a mandatory and valuable option for continuing to provide medical care in various *** the threat of pandemic progress has continued for months and may continue for years,it is essential to validate existing tools to maintain clinical assessment and patient treatment to avoid negative consequences of the lack of medical ***,the establishment of a virtual assessment technique that can be conducted effectively is of outmost importance as a way of adapting to the current *** study evaluated the role of telemedicine in the assessment of various orthopedic pathologies by means of a systematic virtual evaluation.

关键词： Telemedicine Virtual assessment Orthopedics Epidemic diseases

Advances and challenges in the differentiation of pluripotent stem cells into pancreatic β cells

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World Journal of Stem Cells 2015年第1期7卷 174-181页

作者： Essam m Abdelalim mohamed m emara Qatar Biomedical Research Institute Qatar Foundation Education City PO Box 5825 Doha Qatar

Pluripotent stem cells(PSCs) are able to differentiate into several cell types, including pancreatic β cells. Differentiation of pancreatic β cells depends on certain transcription factors, which function in a coordinated way during pancreas development. The existing protocols for in vitro differentiation produce pancreatic β cells, which are not highly responsive to glucose stimulation except after their transplantation into immune-compromised mice and allowing several weeks for further differentiation to ensure the maturation of these cells in vivo. Thus, although the substantial improvement that has been made for the differentiation of induced PSCs and embryonic stem cells toward pancreatic β cells, several challenges still hindering their full generation. Here, we summarize recent advances in the differentiation of PSCs into pancreatic β cells and discuss the challenges facing their differentiation as well as the different applications of these potential PSC-derived β cells.

关键词： Embryonic stem cells Induced pluripotentstem cells Insulin-secreting cells In vitro In vivo Differentiation maturation

New insights on thermal ageing of electrical insulating oils as revealed from photoluminescence and absorption spectroscopy

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High Voltage 2024年第5期9卷 1033-1045页

作者： Hesham S.Karaman Eman G.Atiya Diaa-Eldin A.mansour mohsen Ghali Z.m.S.Elbarbary manal m.emara Department of Electrical Engineering Faculty of Engineering at ShoubraBenha UniversityCairoEgypt Department of Electrical Power and machines Engineering Faculty of EngineeringTanta UniversityTantaEgypt Department of Electrical Power Engineering Faculty of EngineeringEgypt-Japan University of Science and Technology(E-JUST)New Borg El-Arab CityAlexandriaEgypt Department of Energy materials Institute of Basic and Applied ScienceEgypt-Japan University of Science and Technology(E-JUST)New Borg El-Arab CityAlexandriaEgypt Department of Physics Faculty of ScienceKafrelsheikh UniversityKafrelsheikhEgypt Department of Electrical Engineering College of EngineeringKing Khalid UniversityAbhaSaudi Arabia Center for Engineering and Technology Innovations King Khalid UniversityAbhaSaudi Arabia Department of Electrical Engineering Faculty of EngineeringKafrelsheikh UniversityKafrelsheikhEgypt

Recently,significant efforts have been exerted to replace mineral oil with environmentally friendly oils due to safety and environmental ***,there is a need to clarify the physical mechanisms behind the ageing impact of these *** authors use advanced optical spectroscopy techniques in correlation with dielectric measurements to understand the ageing processes in environmentally friendly oils as well as mineral ***,different samples of environmentally friendly oils and mineral oil were utilised to investigate the ageing *** samples were subjected to different ageing periods using a thermal accelerated ageing ***,the severity of the produced byproducts due to the oil degradation is examined based on several measured properties representing macroscopic and microscopic *** macroscopic category was evaluated through dielectric properties,including breakdown voltage,dielectric permittivity,and dissipation *** microscopic category,on the other hand,was assessed using techniques such as ultraviolet-visible absorption spectroscopy and photoluminescence *** techniques enabled a deep understanding of the molecular-level changes occurring in the oil under ageing conditions,thereby getting new insights into oil ageing *** is worth mentioning that natural ester oil demonstrated the most favourable performance across various properties under ageing conditions.

关键词： absorption thermal spectroscopy

Trauma to the solid abdominal organs:The missed dark box of colonoscopy

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World Journal of Gastroenterology 2024年第7期30卷 624-630页

作者： mohamed H emara Usama mazid Yasmine A Elshaer mahmoud A Elkerdawy Dilaver Farooq malik Aya m mahros Department of Hepatology Gastroenterologyand Infectious DiseasesKafrelsheikh UniversityKafr-Elshikh 33516Egypt Department of medicine Alyousif HospitalAlkhobar 31952Saudi Arabia

Colonoscopy is an integral part of the lower bowel care and is generally considered a potentially safe diagnostic and therapeutic procedure performed as a daycare outpatient *** is associated with different complications that are not limited to adverse events related to the bowel preparation solutions used,the sedatives used,but to the procedure related as well including bleeding and *** to the extra-luminal abdominal organs during colonoscopy are uncommon,however,serious complications related to the procedure have been reported infrequently in the *** threatening injuries to the spleen,liver,pancreas,mesentery,and urinary bladder have been reported as early as in *** injuries should not be overlooked by clinicians and *** increasing abdominal pain,abdominal distension,and hemodynamic instability in absence of rectal bleeding should raise the possibility of severe organ *** and hepatic injury following colonoscopy are usually serious and may be life *** conservative management may help,yet they usually need interventional radiology or surgical *** pancreatitis following colonoscopy is usually mild and is mostly managed *** mechanism of abdominal organ injuries during colonoscopy is not fully understood,however many risk factors have been identified,which can be classified as-organ related,procedure related,and local abdominal *** colonoscopy and prior intra-abdominal adhesions are probably the most relevant risk factors for these *** lateral position,avoidance of looping and excessive force during the procedure would probably reduce the risk of such injuries.

关键词： Colonoscopy Pancreatitis Trauma Complications Adhesions

Schistosomal(bilharzial)polyps:Travel through the colon and beyond

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World Journal of Gastroenterology 2023年第26期29卷 4156-4165页

作者： mohamed H emara Aya m mahros Abdelrahman m Ahmed Rasheda mohamed I Radwan Besher mohamed Osama Abdelrazik mostafa Elazab Hassan Elbatae Department of Hepatology Gastroenterology and Infectious DiseasesKafrelsheikh UniversityKafr-Elshikh 33516Egypt Department of Internal medicine Gastroenterology UnitSecurity Forces HospitalRyiadh 11481Saudi Arabia Department of Tropical medicine Zagazig UniversityZagazig 44519Egypt Department of Gastroenterology Surrey and Sussex Hospitals NHS TrustSurrey RH15RHUnited Kingdom Department of Hepato-Gastroenterology and Infectious Diseases Al-Azhar UniversityCairo 11651Egypt

Schistosomiasis(bilharziasis)is a major neglected tropical *** is endemic in many tropical and subtropical *** polyps(***)are not uncommon presentation of this *** the colon is the most commonly affected organ,many other organs are *** are associated with a variable range of morbidity independent of the Schistosomal *** are frequently described in endemic areas and increasingly reported in non-endemic areas mainly among immigrants and visitors to the endemic *** review aimed to increase awareness of practitioners,especially gastroenterologists,for this peculiar type of polyps caused by this neglected infection hence improving patient ***-based search of different databases was conducted for the literature focusing the development of *** in the colon and other organs with analysis of the clinical manifestations,diagnosis and *** following key words were used in the search,“Schistosomiasis”OR“Bilharziasis”AND“Polyps”OR“Polyp”AND“Colon”OR“Small intestine”OR“Duodenum”OR“Stomach”OR“Esophagus”OR”Gallbladder”OR”Pharynx”OR“Larynx”OR“Trachea”OR”Urinary bladder”OR“Ureter”OR“Renal Pelvis”OR“Urethra”.All publication types including case reports,case series,original research,and review articles were retrieved and *** are not infrequent presentation of acute or chronic Schistosomal *** are described in many organs including the bowel,genitourinary tract,skin,gallbladder and the *** of *** is variable and depends on the site,number as well as the polyp *** relationship of *** to malignant transformation is a matter of *** of *** is sometimes the only manifestation of *** polyps can be treated medically with praziquantel,while large accessible polyps are amendable for endoscopic excision through different polyp resection ***,huge,complicated,non-accessible and sus

关键词： Schistosomiasis Bilharziasis Schistosomal polyps Colon Praziquantel

Enhancing Early Detection of Lung Cancer through Advanced Image Processing Techniques and Deep Learning Architectures for CT Scans

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Computers, materials & Continua 2024年第10期81卷 271-307页

作者： Nahed Tawfik Heba m.emara Walid El-Shafai Naglaa F.Soliman Abeer D.Algarni Fathi EAbd El-Samie Computers and Systems Department Electronics Research InstituteEl NozhaHuckstep Cairo12622Egypt Department of Electronics and Electrical Communications Engineering Faculty of Electronic EngineeringMenoufia UniversityMenouf32952Egypt Security Engineering Lab Computer Science DepartmentPrince Sultan UniversityRiyadh11586Saudi Arabia Department of Information Technology College of Computer and Information SciencesPrincess Nourah bint Abdulrahman UniversityRiyadh84428Saudi Arabia

Lung cancer remains a major concern in modern oncology due to its high mortality rates and multifaceted origins,including hereditary factors and various clinical *** stands as the deadliest type of cancer and a significant cause of cancer-related deaths *** diagnosis enables healthcare providers to administer appropriate treatment measures promptly and accurately,leading to improved prognosis and higher survival *** significant increase in both the incidence and mortality rates of lung cancer,particularly its ranking as the second most prevalent cancer among women worldwide,underscores the need for comprehensive research into efficient screening *** in diagnostic techniques,particularly the use of computed tomography(CT)scans,have revolutionized the identification of lung *** scans are renowned for their ability to provide high-resolution images and are particularly effective in detecting small,calcified areas,crucial for identifying earlystage lung ***,there is growing interest in enhancing computer-aided detection(CAD)*** algorithms assist radiologists by reducing false-positive interpretations and improving the accuracy of early cancer *** study aims to enhance the effectiveness of CAD systems through various ***,the Contrast Limited Adaptive Histogram Equalization(CLAHE)algorithm is employed to preprocess CT scan images,thereby improving their visual *** refinement is achieved by integrating different optimization strategies with the CLAHE *** Cutmix data augmentation technique is applied to boost the performance of the proposed model.A comparative analysis is conducted using deep learning architectures such as InceptionV3,ResNet101,Xception,and *** study evaluates the performance of these architectures in image classification tasks,both with and without the implementation of the CLAHE *** empirical findings of the study demonst

关键词： Lung cancer detection CLAHE algorithm optimization deep learning classification feature extraction healthcare applications