Ashry, A., A. T. Mahmoud, and M. Gabr, "Delayed recovery from paraplegia following resections of thoracic meningiomas.", Surgical neurology international, vol. 11, pp. 321, 2020. Abstract

Background: In this retrospective study, we evaluated the patterns of postoperative recovery for patients who were initially paraplegic before the excision of thoracic spine meningiomas. We also determined how the various prognostic factors impacted outcomes.

Methods: Twenty patients with paraplegia underwent surgical excision of thoracic spine meningiomas at 2016- 2019. Patients' demographics, clinical, radiological data, operative details, histopathology, and postoperative complications were recorded; patients were reassessed at 6 months and 1 year postoperatively.

Results: Fourteen patients improved postoperatively, becoming, ambulatory with/without assistance; only six remained paraplegic. Poor prognostic factors for postoperative motor recovery included larger tumor size, longer duration of preoperative symptoms/paraplegia, and greater severity of sensory loss.

Conclusion: For 6/20 patients with thoracic meningiomas, poor postoperative recovery of motor function correlated with larger tumor size, longer duration of preoperative symptoms/paraplegia, and more severe sensory loss.

Ashry, A. H., H. M. Soffar, and M. F. Alsawy, "Neurosurgical education during COVID-19: challenges and lessons learned in Egypt.", The Egyptian journal of neurology, psychiatry and neurosurgery, vol. 56, issue 1, pp. 110, 2020. Abstract

Background: The coronavirus pandemic (COVID-19) has disrupted the routine neurosurgical education and practice worldwide and so more in developing countries. Continuing the neurosurgical training while maintaining the well-being of our residents should be the primary concern of leaders of training programs.

Objectives: The aim of this cross-sectional study was the evaluation of the impact of COVID-19 on neurosurgical residency programs and neurosurgical practice in five tertiary medical centers in our country. We also aimed at detecting the shortcomings in training programs and provide solutions.

Methods: An online questionnaire-based survey was prepared and sent to 73 neurosurgery residents in 5 tertiary centers in 4 governorates by social networks. The questions focused on the evaluation of clinical and surgical activities before and after the pandemic. Safety precautions, education, and residents' mental health were also evaluated.

Results: Fifty residents responded to our survey. We identified a significant reduction in surgical cases, inpatient services, and working hours per week during the pandemic comparing to the pre-pandemic era. We also identified a significant increase in research hours and changes in educational methods from in-person methods to virtual ones. Seventy-four percent reported that personal protective equipment was not adequate for their duties. Sixty-eight percent experienced burnout symptoms. Unavailability of personal protective equipment, negative concerns regarding the surgical career, and financial strains significantly affected the mental health of residents.

Conclusions: The survey highlighted the negative impact of COVID-19 on neurosurgical practice and education. Being in a developing country, this negative effect was amplified due to financial reasons and weak infrastructure. Inadequate personal protective equipment increased the risk of infection and work-related stress among neurosurgery residents. We lacked telemedicine services in our country. Online education gained more visibility and awareness.

Ashry, A. H., and M. F. Alsawy, "Doctor-patient distancing: an early experience of telemedicine for postoperative neurosurgical care in the time of COVID-19.", The Egyptian journal of neurology, psychiatry and neurosurgery, vol. 56, issue 1, pp. 80, 2020. Abstracttelemedicine.pdf

Background: Telemedicine remains an important tool of healthcare services delivery especially in the era of the COVID-19 pandemic. Its advantages include saving the time and money of the patients and the prevention of infection among healthcare providers.

Objectives: In this study, we aim to evaluate the effectiveness and safety of telemedicine visits in providing postoperative care of neurosurgical patients.

Materials and methods: We conducted this prospective study on 30 neurosurgical patients who were evaluated after surgery via telemedicine visits for 30 days. During the virtual visits, we discussed the clinical progress of patients, wound status, treatment modification, the time of return to work, postoperative complications, and the radiological data of the patients. All the patients were given an emergency number to call in case of urgent issues. The satisfaction of patients and doctors was measured with the aid of two questionnaires.

Results: The patients' age ranged from 18 to 65 years. Twenty patients were male and 10 patients were female. We performed 20 cranial operations and 10 spinal operations. Most patients needed more than 4 h to reach the hospital. The total number of telemedicine visits was 67 visits. We received about 62 emergency calls. Pain management, seizures control, wound infection, and hydrocephalus is among issues that were evaluated and managed via telemedicine visits. The overall satisfaction rate among patients and doctors was 90% and 95%, respectively.

Conclusion: Virtual outpatient clinics seem to be a safe and effective way of postoperative care especially in the time of the COVID-19 pandemic.

AHMAD H. ASHRY, M. S., M. D. WAEL M. AL-MAHDY, M. D. AHMAD S. HASSAN, M. D. OMAR M. AL-FALAKY, and M. D. MOHAMMED A. THABET, "Anterior Cervical Discectomy with Fusion Versus Posterior Cervical Foraminotomy in Single Unilateral Cervical Disc Prolapse", kasralainy journal of medicine , vol. 1, issue 6, 2016. Abstract

Objective: The aim of this work is to evaluate the role of posterior cervical foraminotomy for the treatment of cervical radiculopathy caused by single level cervical disc lesion as compared to anterior cervical discectomy and fusion by cage. Methods: Prospective randomised comparative study of a clinical series of 30 patients with unilateral cervical radiculopathy treated by either anterior cervical discectomy or fusion by cage (15 patients) or posterior cervical foraminotomy (15 patients) in Cairo University Hospitals. Results: Average age of presentation was 39 years. Males were more affected then females. Right sided radiculopathy was more commonthan left side. The most common operated level was C5-6. Excellent and good outcomes were obtained in 80% of the patients in ACDF group and 60% in posterior foraminotomy group. Conclusion: ACDF is superior to posterior cervical foraminotomy in treatment of single unilateral posterolateral cervical disc disease regarding operative time ,post operative hospital stay, complications, improvement of symptoms and short term follow up.