bluuebunny/crossref_metadata_2025 huggingface dataset:
Palm ridge density as anew identifier for age and sex in forensic medicine
Authors: Mohamed K M , Gaballah E M F , Zaghloul H S , Ismail M M
Published: May 2020

Background

Palm print recognition is a biometric technology which recognizes a person based on his/her palm print pattern. Palm print serves as a reliable human identifier because the print patterns are not duplicated in other people, even in monozygotic twins. More importantly, the details of these ridges are permanent

Method: In the current study, The four prominent areas were analysed on the palm prints that included central prominent part of the thenar eminence (P1), hypothenar region; inner to the proximal axial triradius (P2), medial mount; proximal to the triradius of the second digit (P3) and lateral mount; proximal to the triradius of the fifth digit (P4). areas were taken, by inking method, from 200 healthy Egyptian subjects of different ages and both sexes (113 males and 87 females). Ridge count per 25mm2 was determined together with assessment of ridge pattern type. The subjects were divided into four age groups; from 6-<12, from 12-<18, from 18-<40 and ≥40 years

Results

Females had higher palm ridge density in all palm areas as well as total in both hands than males, there was a statistical significant difference in mean ridge density of individual palm areas as well as total of both hands, between different age groups within males and females separately (p < 0.001**), except in left P1 and P4 in females. There was a statistical significant negative correlation between the age and ridge density of the right hand p2, There was a highly statistical significant difference between the ridge density in the Left hand P3 and right hand p3 and between Left hand p4 and right hand p4 (p < 0.0001** for both) in both males and females but there was no statistical significant difference between Left hand P1 and right hand p1 as well as between the Left hand p2 and right hand p2 in both males and females, There was a highly statistical significant difference between all areas of right hand in both males and females (p < 0.05) There was a highly statistical significant difference between all areas of left hand in male and female except between left p4- p1

Conclusions

In the current research, we were able to prove that palm prints ridge density can be help in gender and age identification.
Assessment of permanent teeth eruption in a sample of Egyptian primary school children
Authors: Magdi M M , Kotb N A , Elbarrany U M , Ramadan H S , Mowafy M A
Published: May 2020

Background

Parents have often showed their interest in the tooth eruption timing. However, the literature suggests that tooth emergence standards should be derived from the population they are to be applied because emergence related factors may vary considerably in dentition. Timing of teeth emergence differs from population to population and can be affected by genetic and environmental factors. Both ethnic origin and gender can be attributed to genetic factors.

Objectives

The purpose of the present study was to find out the statistical correlation between age, sex and stature to eruption of permanent teeth in a sample of primary school children age (6-<13 years).

Methodology: The present study was a cross sectional study that was conducted on 700 healthy school children aged 6 – <13 years selected from different primary schools in two governorates in Egypt; Behera governorate and Giza governorate. Assessment of age, sex and stature was performed through socio – demographic data, anthropometric measures and sequence of permanent teeth eruption.

Results

The first molars, central incisors, upper lateral incisors, lower canines, second premolars and second molars erupted earlier in Behera (Rural) children. The mandibular teeth tended to precede the maxillary teeth. In Giza (urban) children most of the teeth erupted earlier in girls. In Behera (Rural) children most of the teeth erupted earlier in boys.

Conclusion

Most of teeth erupted earlier in Behera (rural) and the majority erupted earlier in girls in Giza (urban) and in boys in Behera (rural).
Role of Laparoscopy in Management of Nonpalpable Undescended Testis in Children
Authors: Ibrahim E F , Abdelameguid S M , Hussein A S , Abdelhai I A A
Published: May 2020

Background

Normal testicular descent relies on a complex interplay of numerous factors. Any deviation from the normal process can result in an undescended testis (UDT). UDT is a common abnormality that carries fertility and malignancy implications.

Aim of the Work

The aim of this study is Evaluation of the role of laparoscopy in diagnosis and management of clinically impalpable testis.

Patients and Methods

Nineteen male patients were included in this study with twenty two non-palpable testes. All these patients were subjected to diagnostic laparoscopy & the subsequent decision was then based on the laparoscopic finding. There was no age limit for the procedure. The procedure was carried in Ain Shams University teaching hospital and El-mataria teaching hospital.

Results

The study included nineteen patients with twenty two non-palpable testes. Age at presentation was averaging 18.5 ± 12.5 months. Our study may present convincing evidence that laparoscopy has significant advantage over imaging procedures. Preoperative imaging proved inaccurate in determining testicular position in 10 of the 22 testes (45.5%) this is in agreement with many studies which reported that ultrasonography helped to identify only 45% of non palpable testis.

Conclusion

This study tried to assess roughly the effectiveness of laparoscopy as a diagnostic tool and treatment of non-palpable undescended testis. This study dealt with a very small number of patients and this issue still needs more researches to study all the benefits and disadvantage and shall need further study on a wide range of patients.
Comparison Between Abdominoplasty Assisted by Liposuction Utilizing Classical (U) Incision Versus (W) Incision: A Randomized Controlled Study
Authors: Abdrabo A A , Elsayed M G , Kabeel A M A
Published: May 2020

Background

Traditional abdominoplasty techniques, which use primarily transverse incisions, seem to be most beneficial for those patients whose abdominal contour is relatively normal with only a minimal to moderate amount of flaccid skin.

Objective

The aim of the study was to compare between the results of two different incisions used in abdominoplasty with liposuction, and to detect the morbidities and complications which may occur after the surgical procedures such as Aesthetic complication which occured in the form of asymmetry, dog ears, residual deformity, unsatisfactory umbilicus and unsatisfactory scarring (widened, thickened, hypertrophic or keloid) and Non-aesthetic complications which occurred in the form of seroma, wound infection, partial skin necrosis, and wound dehiscence. In addition to comparing the aesthetic outcome and patient satisfaction.

Patients and Methods

The contour of the abdomen is the backbone of body contouring surgery. Patients usually seek abdominoplasty for abdominal wall laxity, excess skin, striae, or diastasis of the rectus muscles. The inevitable end scar must be invisible as possible, symmetrical, and located in regions covered with the minimal clothing. The study included 30 patients divided into 2 groups (A) & (B) each group consist of 15 patients. This study was a prospective comparative study between Classic (U) incision abdominoplasty and (W) incision abdominoplasty; Group (A) undergone Classic (U) incision abdominoplasty, and Group (B) undergone (W) incision abdominoplasty. Results: received from both groups were compared to each other and the collected results were evaluated, and subjected to statistical analysis . Patient satisfaction was assessed by direct patient questioning and included subjective and objective feedback on the overall satisfaction following abdominoplasty, areas of dissatisfaction and patients satisfaction post different types of abdominoplasty.

Conclusion

Abdominoplasty with Liposuction provide high levels of patient satisfaction. The combined procedure is similar in discomfort level to abdominoplasty alone and produces the highest level of patient satisfaction and the patient satisfaction represents a golden goal in the practical work.
The Relation Between the Distance of Rectus Plication and the Intra Abdominal Pressure Changes before and Immediately After Abdominoplasty
Authors: Alshafaai M A , Omran H M , Lashin R Z A , Mohammed H K
Published: May 2020

Background

tummy tuck surgery, also known as abdominoplasty, removes excess fat and skin and, in most cases, restores weakened or separated muscles creating and abdominal profile that is smoother and firmer. Diastasis recti means the belly sticks out because the space between left and right belly muscles has widened. The most notable symptom of anterior abdominal wall weakness or diastasis recti is a noticeable protrusion in the stomach. This protrusion is caused by weakness and separation of the muscles in the mid-abdomen.

Objective

It was to evaluate the relationship between the distance of recto-fascial or recto-fascial diastasis placation and intra-abdominal pressure changes during and immediately after abdominoplasty.

Patient and Methodology

In this study we demonstrated if there was relation between rectus diastasis width and the increase of intra-abdominal pressure, to evaluate this correlation before and immediately after the plication of anterior rectus sheath in abdominoplasty. Seventy five meeting the inclusion criteria were selected.

Results

This study enrolled 75 healthy female patients, the study took place at Al-Jamila Hospital, performed in a period of 10 months, starting from March 2017 till December 2017.
Sleeve gastrectomy with loop bipartition as a novel procedure for management of type 2 diabetes in obese patients
Authors: Ezz R S , Abouzeid M M , Helmy M M , Elhusseini M M
Published: May 2020

Background

Amidst the current worldwide epidemic of type 2 diabetes mellitus (T2DM), the global diabetes health burden is projected to reach 522 million in 2030, with much of this increase occurring in developing countries.

Aim of the work

to evaluate the role of laparoscopic sleeve gastrectomy with loop bipartition (single anastomosis sleeve ileal bypass) as a bariatric and metabolic procedure in control of type 2 diabetes in obese patients.

Patients and methods

This prospective cohort study included 20 obese adult patients with type 2 DM recently diagnosed within last 5 years. Some of them have other associated comorbidities. They were recruited at department of surgery Ain Shams University. The follow up was obtained during the first year post-operative.

Results

In this study, complete remission of diabetes was achieved in 75% of the patients by the 3rd post-operative month and in 95% by the end of the study. This was beside marked weight reduction and improvement of lipid profile without causing micronutrients deficiencies during the study period.

Conclusion

SASI bypass can be one of the most efficient metabolic procedures and could be associated with less risks. The procedure should be considered under investigations until enough long term data are available. Thus it is worth to be explored in research aiming for more data.
Transversus abdominis release versus perforator preseving anterior component separation in repair of large midline incisional hernia
Authors: Abdallah A K , Gad K H , Darwish A A , Abdelmaksoud I M
Published: May 2020

Background

Ventral hernia repair can be challenging, particularly in patients with serious comorbidity. Perforator preserving anterior component separation (ACS) by transverse skin incisions for external oblique aponeurosis release preserves both the rectus abdominis myocutaneous perforator vessels that supply the overlying skin and the connection between the subcutaneous fat and anterior rectus sheath, thereby reducing subcutaneous dead space and potentially improving overlying skin flap vascularity. Also posterior component separation via transversus abdominis release (TAR) provides effective fascial advancement while reducing wound morbidity during abdominal wall reconstructions. Both techniques give better results than classic ACS.

Objectives

to evaluate postoperative morbidity and recurrence rate when using transversus abdominis release technique in management of large midline incisional hernia in comparison with open perforator preserving anterior component separation.

Patients and Methods

the present study is a prospective study that was conducted at Ain Shams University Hospitals in Egypt, between October 2016 and October 2018. It included sixty (60) patients with large midline incisional hernia divided into two groups. First group include thirty patients who underwent transversus abdominis release with retromuscular polyprolene mesh placement. Second group include also thirty patients that underwent open perforator preserving anterior component separation and also with retromuscular placement of polyprolene mesh. Patients compared as regards operative time, length of hospital stay, postoperative pain, postoperative ileus, postoperative wound complications, rate of recurrence.

Results

Patients in both groups were similar with respect to age, the patients ages ranged from 20 to 70 years, with mean age in both groups around 46 years and between 20-23% have DM in each group. Perforator preserving technique has less operative time by about 40 minutes when compared with TAR technique. The postoperative pain assessment at 48hrs postoperative show that the mean pain score for TAR was (6.77 ± 1.70) and for perforator preserving group (5.47 ± 1.85). We also found that the mean hospital stay was slightly higher when performing TAR technique (5.2days) while it was (4.3days) after perforator preserving approach. There is nearly equal incidence of postoperative wound complications and also no statistically significant different rate of recurrence between two methods

Conclusion

both TAR and perforator preserving technique are effective and reliable method in experienced hands and if there is no special indication to one of them, the choice between both should depend on surgeon preference and experience.
Effects and Results of Omentopexy During Laparoscopic Sleeve Gastrectomy on Possible Post Operative Bleeding and/or Leakage
Authors: Saber E S , Ibrahim A M , Benjamine F M
Published: May 2020

Background

In laparoscopic sleeve gastrectomy, patients may experience some post-operative complications as hemorrhage or leakage.We aim by this study to evaluate the benefit of omental fixation with full thickness stitches in decreasing post-operative hemorrhage and leakage, and the mutual effect on the patient and the surgeon.

Methods

A retrospective analysis of collected data including 200 laparoscopic sleeve gastrectomy (LSG) from September 2016 to September 2018, procedures were divided into two groups, group A of 100 LSG procedures without omental fixation but clipping the whole suture line with titanium clips if any bleeding point present, and group B 100procedures with omental fixation with full thickness stitches till the level of incisura above, and below with titanium clips to control bleeders if present.

Results

Of group A there were 9 cases of leakage needed intragastric stent and feeding jejunostomy (0.9%), 26 cases of bleeding (2.6%) 15 cases of them needed relaparoscopy and ful lthickness stitches (1.5%) and 11 cases of them managed conservatively with blood transfusion (1.1%), and 3 cases of perigastric localized collection managed by pigtail and antibiotics (0.3%), average operative time was 55 minutes (between 35-75 minutes).Of group B there were 8bleeding cases of drain with less than 300 cc were managed conservatively (0.8%), and 1 case of perigastric localized collection managed conservatively without pigtail (0.1%), No leakage was identified nor hematoma, average operative time 85 minutes (between 50 to 120 minutes).

Conclusion

The step of omental fixation with full thickness stitches has shown to be effective in decreasing staple line bleeding and leakage although it minimally prolongs the operative time of LSG.
Prospective Study Comparing the effect of Laparoscopic Mini Gastric Bypass and Laparoscopic Sleeve Gastrectomy on Blood Glucose Level in Type 2 Diabetes Mellitus Obese Patients
Authors: Shaker H Z , Abdelaziz M Z , Abdelaziz M M , Afify A H , Mohamed A M S
Published: May 2020

Background

Type 2 diabetes mellitus (T2DM) is now a global health priority. The World Health Organization estimates that between 2000 and 2030, the number of diabetic patients will increase by 114%. T2DM and morbid obesity are conditions representing increasing public health threats. They are associated with significant morbidity and mortality, and despite lifestyle modifications and medical support, glycemic control remains difficult to achieve in obese diabetic patients.

Objective

To compare the effect of laproscopic mini gastric bypass and laproscopic sleeve gastrectomy in controlling type 2 DM obese patients.

Patients and Methods

Our study was conducted on 40 adult morbid obese patients with T2DM. Twenty patient underwent laparoscopic mini-gastric bypass and the other 20 patient underwent sleeve gastrectomy. All of these patients were followed up preoperative and postoperative at 1, 3, 6, 9 and 12 months by measuring BMI, EWL%, Fasting blood glucose level, 2 hours post prandial blood glucose level, HbA1C also postoperative gastrografin study to exclude complications.

Results

Our study demonstrated the superiority of MGB over SG in controlling T2DM along 1 year of follow up with lower 1 year HBA1C, FBG, 2HPP blood glucose level in bypass group in comparison with SG group. The results of our study regarding mini gastric bypass MGB patient group showed total remission rate (85%), the other 15% of patients achieved improvement of glycemic control, regarding antidiabetic treatment only 3 out of 20 needed postoperative treatment. The results of our study regarding sleeve gastrectomy patient group showed total remission rate (50%) the other 50% of patients achieved improvement of T2DM control, regarding antidiabetic treatment 9 out of 20 needed postoperative treatment.

Conclusion

late postoperative complications and long-term maintenance of glycemic control need to be determined by further studies on a larger scale of patients and bigger duration of follow up.
Comparative Study between Complications of Abdominoplasty after Weight Loss by Bariatric Surgeries versus Weight Loss by Non Surgical Methods
Authors: Aamer M A , Eskandaros M S , Metwali M A N
Published: May 2020

Background

The abdomen plays a leading role in the aesthetic image of the human body, and is of prime importance in defining the overall contour of the individual. The abdomen is cited as the location with the most severe deformities after weight loss and the deformities are highly variable.

Objectives

The aim of this study is to compare between complications of abdominoplasty after weight loss by bariatric surgeries versus weight loss by non surgical methods according to operative time, intraoperative complications: bleeding, postoperative complications: seroma, hematoma, infection, wound-healing problems, and skin flap necrosis and final aesthetic outcome.

Patients and Methods

This study includes forty patients with abdominal wall redundancy after bariatric surgeries and non surgical methods. All the patients will be examined as regards age, sex, weight, height, BMI, general examination, co-morbidities & associated ventral hernia. This study was conducted in 6 months between April 2017 and October 2017 on patients who were admitted to El Demerdash hospital or authorized medical institutions under supervision of thesis supervisors.

Results

In this study the mean age of the post bariatric group was 44 years and the non surgical group was 42.4 years. The mean BMI of the post bariatric group was 29.9, a little higher than the non surgical group which was 28. The Pre - loss BMI of the post bariatric group was higher than the non surgical group. The ideal lost weight, actual lost weight and percent of lost weight of the post bariatric group was higher than the non surgical group. The resection weight and the operative time of the post bariatric group were higher than the non surgical group. The amount of drain day1, total amount of drain l& drain removal day of the post bariatric group was higher than the non surgical group.

Conclusion

To conclude, abdominoplasty after weight loss by bariatric surgeries has higher risk of complications more than abdominoplasty after non surgical methods.
Comparative Study between Extended Latissimus Dorsi Flap and Skin Sparing Mastectomy with Subpectoral Silicone Implant
Authors: Elfeky A K , Elshinawi M E , Othman A G , Hafez R F , Elnaggar A M M L
Published: May 2020

Background

Breast cancer is the commonest malignancy in women. It is the most common cause of cancer death among women worldwide. The female breast is a potent symbol of maternity and femininity. For many years after a mastectomy, many women experience psychological distress and feel that her everyday life has been disputed.

Objectives

Extended LD flap and skin sparring mastectomy with subpectoral silicone implants are widely used in breast reconstruction. The current study is conducted to report our initial clinical experience with both techniques and better assessment of the cosmetic outcome and complications.

Patients and Methods

This study was held at Ain Shams University Hospitals between period (1/3/2018 – 31/1/2019) and the number of Participants were 30 Patients, Divided equally in to 2 Groups:

group A

had an extended latissimus dorsi flap,

group B

had skin sparring mastectomy with sub- pectoral silicone implant. This research is approved by ethics committee (IRB).

Results

We were able to conduct an excellent cosmetic outcome with 53.2% of the cases (16 patients) falling in excellent and good score groups. Another 46.7% (14 cases) which fall in fair and poor score groups. None of our cases have had an ugly score.

Conclusion

The combination of plastic surgery techniques with breast oncology surgery gives the surgeon a new tool for treatment of breast cancer. This approach has enabled us to increase the number and extend the indications of breast conserving surgery with wider margins offering safer oncologic control with more satisfactory cosmetic outcome.
Comparison between Stenting and Stentless Technique in Biliary Anastomosis after Living Donor Liver Transplantation
Authors: Abdelaal A A , Hassan M A M , Aboelnaga M A M , Rayan M T
Published: May 2020

Background

billiary complications is the most common complication after LDLT. Biliary complications include stricture, leakage, cholangitis, biliary stones, hemobilia and ductopenia. Risk factors of complications include advanced donor age multiple anastomoses, long cold and warm ischemia times, hepatic artery thrombosis and duct-to-duct reconstruction.

Aim of the Work

it is a combined retrospective and prospective analytical study to compare between using stent and stentless technique in biliary anastomosis in living donor liver transplantation.

Patients and Methods

in this observational study we did comparative study between stented and stentless technique. We compared the main complications; leakage, stricture and cholangitis. Diagnosis of each complications is built up by follow up serum liver profile, and Ultrasonography. We did MRCP to diagnose stricture and follow up drains or aspiration of any collection to confirm leakage. All cases of cholangitis was admitted to our hepatobiliary unit to control the condition and to exclude any concomitant stricture or leakage.

Results

there is a significant decrease in the previously mentioned postoperative biliary complication using stentless technique by decreasing biliary infection rate and, thus, decreasing stricture and leakage. Managment of complicated case was initially done by hospital admission. ERCP was done for all cases of sticture.

Conclusion

biliary complications after living donor liver transplant can significantly be reduced by using stentless techinque.
Role of Laparoscopy in Treatment of Diaphragmatic Hernia in Adult
Authors: Almenawy A A , Almaraghy A M , Farahat M S , Nageeb R M
Published: May 2020

Background

congenital diaphragmatic hernia in adult is a rare condition, most of cases are asymptomatic and discovered accidental. We reported 10 cases of diaphragmatic hernia repaired successfully via the laparoscopic approach.

Objectives

to describe the role of laparoscopy in treatment of congenital and traumatic diaphragmatic hernia in adult.

Methods

prospective study was conducted on 10 adult patients suffering from diaphragmatic hernia to evaluate the role of laparoscopy in treatment of diaphragmatic hernia in adult. The study was conducted at general surgery department of Ain shams university hospitals and Kafr ash Shaykh general hospital including all symptomatic types of diaphragmatic hernia on both adult male and female patients with age more than 18 years.

Results

We achieved satisfactory intracorporeal repair of these diaphragmatic defects. The patients had excellent recovery and started on oral diet one to two days postoperative except one patient (10%) started on the 5th day due to resection anastomoses, and then were discharged with symptomatic relieve after surgery.

Conclusion

The minimally invasive advantage of laparoscopic approach offers a secure, reliable and satisfactory way to confirm the diagnosis and achieve the repair of diaphragmatic hernia.
A Comparative Study between Traditional Care Program and Enhanced Recovery after Surgery (ERAS) Program in General Surgery
Authors: Abadir A F , Benjamine F M , Aziz A H F
Published: May 2020

Background

Enhanced Recovery after Surgery (ERAS) programs have been very important to surgeons who are keen to decrease postoperative morbidity, reducing variability in postoperative care and minimizing hospital costs

Aim of the Work

This study aims to assess the safety and efficacy of enhanced recovery after surgery programs in general surgery in comparison with traditional care.

Patients and Methods

The present prospective study was conducted at the General Surgery Department, Ain Shams University Hospitals in Cairo, Egypt from September 2017 to June 2018 on 80 patients undergoing general surgical interventions. Patients were randomly distributed into 2 groups: Group A (n = 40) for conventional protocol (control group) and Group B (n = 40) for enhanced recovery protocol (ERAS group).

Results

Patients of both groups passed the procedure efficiently without any intraoperative complications. The mean operative time was 155 minutes in control group and 160 minutes in ERAS group, this wasn’t statistically significant (P > 0.05). The mean amount of blood loss was 150 ml in control group and 175 ml in ERAS group which was also insignificant (P > 0.05). Mean length of hospital stay (LOS) was 3.05 in group A versus 1.2 in group B which was highly significant (P < 0.001).

Conclusion

ERAS pathway was shown to be feasible for application in general surgery as it shortened postoperative hospital stay and showed no increased risk to patients in terms of morbidity or mortality.
Care of Breast in Pregnant and Lactating Females
Authors: Soliman Al-shaimaa G , Abdelrahman S A , Darweesh A A , Gerges W B , Tantawy H S
Published: May 2020

Background

Brest feeding is an important process that’s not only important for baby nutrition but also it strengthens the relation between the mother and her baby. Female breast undergoes multiple physiological changes during pregnancy and lactation.if the female not well educated about them and how to deal with them it will be a source of great horror to the female and her family as they consider any pain or unknown change in the breast as cancer until proved otherwise.

Objective

To assess breast care during pregnancy and its preparation for lactation and the value of this care in preventing breast infection.

Patients and Methods

This is a prospective study included 85 female patients coming to breast clinic and obstetric clinic of El Demerdash Hospital from September 2017 to August 2018. 40 of them presented during the third trimester of their pregnancy and the remaining 45 presented during lactation period. Sixty –three of them were multipara, the others were primigravida. Thirty of them gave a history of problems with previous lactation.

Results

In our research, females who came and were followed during pregnancy were educated about the importance of breast feeding to the baby and to the mother during their visits to the obstetric clinic. They were taught how to take care of their breast preparing it for safe and comfortable nursing. 35% of them were previously suffered from breast engorgement in previous lactation but when they followed our instructions about 27% of them developed breast engorgement which relieved rapidly without progressing to further complications. Also 5% previously developed breast abscess which was avoided in current study. We had also two of our participants that had retracted nipple one of them had previous experience of lactation that stopped shortly after birth but when we reassure her and learn her how to prepare her nipples by gentle massage, lubricants and use of plastic shells after delivery she could overcome her problem and continue breast feeding. Females who came during lactation were not prepared properly during pregnancy and 44% of them suffered from breast engorgement which was relieved with proper management but one of them developed breast abscess.

Conclusion

Every female have to learn about the right position of nursing and how to make proper care of her breasts and when she has to seek medical advice. This will help her to adapt the act of nursing and overcome any annoying problem that she may face during this period.
Comparative Study between Mass Closure and Hughes Repair in Emergency Laparotomy
Authors: Ebied E F , Khalil A A , Soliman A M
Published: May 2020

Background

Exploratory laparotomy remains one of the common operations across the surgical disciplines. As such, the systematic and safe closure of such a laparotomy wound is the key to reduce the postoperative morbidity like wound pain, wound infection and incisional hernia.

Objective

To compare mass closure & Hughes repair in emergency laparotomy as regard intraoperative technique, operation time, incidence of complication as wound infection, dehiscence, burst abdomen and incisional hernia.

Patients and Methods

This is a prospective comparative study between two types of closure, mass closure and hughes repair in emergency laparotomies. This study was conducted at Ain-Shams University Emergency Hospitals. Patients who underwent emergency laprotomy from September 2017 to March 2018 and the patients were followed up postoperatively for six months. All patients who underwent emergency laparotomy at Ain-Shams University Emergency Hospitals from September 2017 to March 2018 were chosen according to inclusion and exclusion criteria.

Results

In this study we used the same suture and materials” Polydioxanone PDS loop 1”. The comparative study included several items to discuss starting from the time of the technique in our study it ranged from 12 -19 minutes in the conventional method “Mass closure” and it ranged from 24-31 minutes in the huge repair group. It was observed that the length of the laprotomy incision determine the time of the technique. The overall operative time of mass closure group was shorter than the hughe repair technique

Conclusion

It was observed that there were major factors that affected the results such as the reason for the laparotomy and the general condition of the patient especially the chest condition, diabetes mellitus, serum albumin, anemia and the body mass index.
Role of Single Anastomosis Gastric Bypass Surgery in Class-I Obese Diabetic Patients
Authors: Sabry A A , Abdel-Samee K S , Kamel K A
Published: May 2020

Abstarct

Background

bariatric surgery was originally designed to induce weight-reduction in morbidly obese patients. Benefits of bariatric surgery, however, extend well beyond weight loss and include dramatic improvement of type 2 diabetes, hypertension, dyslipidemia and reduction of overall mortality.

Aim of the Work

to evaluate the metabolic and weight loss effect of single anastomosis gastric bypass surgery in Class-1 obese diabetic patients type-2 in the first year postoperative follow up.

Patients and Methods

this study included 40 mild-obese patients (Class-I) with T2DM with one or both of the following (hypertension and hyperlipidemia) treated by laparoscopic Mini-Gastric Bypass.

Results

the mean BMI loss after one year from MGB surgery was (6.8 ± 1.1 kg/m2). Complete resolution of diabetes occurred was in 82.5% at 12 months and cases with no remission in DM was 0%. Regarding the Hypertension, resolution of Hypertension was 63.6%. improvement was 23% and no change in Hypertension status was 13.6%. Regarding Hyperlipidemia; resolution of Hyperlipidemia was 62.5%, improvement was 21% and no change in Hypertension status was 16.5%.

Conclusion

bariatric surgeries (MGB) is not only a weight-reducing surgery but a metabolic surgery which can cure most of the metabolic syndrome and it is considered the most effective long term treatment modality for type 2 diabetes in mild-obese patients, our study suggests that MGB is highly effective in controlling diabetes, hypertension and hyperlipidemia.
Comparison between Immediate and Delayed Prosthetic Breast Reconstruction Following Mastectomy
Authors: Wassef B A , Hassan W H , Ahmed R M , Shebl E S
Published: May 2020

Purpose

to compare the outcomes of Immediate versus Delayed prosthetic breast reconstruction. Together with highlighting the importance of immediate reconstruction when it is feasible.

Materials and methods

This was a prospective study that was held at ain shams university hospitals and Helwan university hospital. The study included 20 patients who were planned to undergo a mastectomy either unilateral or bilateral, patients were divided equally in to 2 groups, (Group A) had an immediate breast reconstruction using mammary implants, while (Group B) had a delayed breast reconstruction using tissue expander then replacing it after a few months with a mammary implant, and the post operative complications were compared against each other.

Results

Although the number of complications were more in (Group A), but statistically it was found that the rate of complications after immediate reconstruction was non significant from after delayed reconstruction.

Conclusion

both immediate and delayed mastectomy reconstruction provide substantial safety and quality of life benefits for women choosing these procedures. Furthermore, patients who postpone reconstruction after mastectomy due to personal preference or by medical necessity can be reassured that this approach is a safe alternative to immediate reconstruction and can provide equivalent quality of life and body image benefits.
Outcome of Anticoagulant Therapy Following Bariatric Surgery
Authors: Yousef A M , Mohamed A F , Elshayeb B H , Abdelmalak G M
Published: May 2020

Background

Bariatric surgery remains the most effective means of treating severe obesity. The number of severely obese patients is increasing and, consequently, more people are seeking bariatric surgery.

Aim of the Work

The Aim of This Study is to Outcome of Anticoagulant during Bariatric Surgery and Relation of Bariatric Surgery to Coagulopathy Disease.

Patients and Methods

This prospective study was conducted on 50 morbidly obese patients admitted to Hospital (Ahmed Maher Teaching Hospital and Ain Shams University Hospitals), for a primary one-stage laparoscopic bariatric surgery procedure over a 6-month period. The study is performed on 50 Patients, Who met all Inclusion criteria and none of Exclusion criteria.

Results

The study revealed no statistically significant difference between Enoxaparin and Rivaroxaban according to outcome of anti-coagulation therapy following bariatric surgery.

Conclusion

a high protective value of Chemical Thromboprophylaxis combined to Mechanical Thromboprophylaxis in preventing DVT safely. New Oral Anticoagulant drugs showed equal and may be superimposed the other traditional anticoagulant, but it needs more studies regarding its prophylactic dose, number of patient and its cost benefit in comparison with other Anticoagulant drugs were used in our study or other studies we mentioned above.
Comparative Study on Effect of Mesenchymal Stem Cells and Endothelial Progenitor Cells on Treatment of Experimental CCL4 Induced Liver Fibrosis
Authors: Sabry D , Khalifa W A , Abdelgwad M M , Alhelf M , Altaib Z M
Published: May 2020

Background

Bone marrow mesenchymal stem cells (BM-MSCs) and human umbilical cord endothelial progenitor cells (UC-EPCs) have several benefits for liver regeneration. We speculate huge impacts of rat BM-MSCs and UC-EPCs on reversal of hepatic injury and improvement of liver function in liver fibrosis induced by carbon tetrachloride (CCl4).

Methods

Forty adult rats were divided into 4 groups; control group, CCl4 group, CCl4/BM-MSCs group and CCl4/UCEPCs group. Blood samples were driven from rats at 1, 2 and 3months to measure serum concentration of albumin and alanine aminotransferase (ALT). Quantitative expression of HGF,TGF-β, MMP-2, and VEGF were assessed by polymerase chain reaction. Histological examination of the liver tissue was performed. α-SMA immunohistochemistry to identify the myoepithelial cells (MECs) and Ki-67 to identify cell prolifration immunohistochemistry are detected in groups injected with cells to confirm cells regeneration.

Results

Regarding liver function, there was elevating albumin (P < 0.05) and reducing ALT (P < 0.05) concentrations in groups treated with BM-MSCs and UC-EPCs effect compared to untreated CCL4 group. Concerning gene expression, UC-EPCs treated group have significantly higher MMP-2 and VEGF (P < 0.01) genes expression than BM-MSCs treated group. Furthermore, UC-EPCs were more valuable than BM-MSCs in increasing gene expression of HGF (P < 0.05) and immunohistochemistry of α-SMA and Ki-67 (P < 0.01). BM-MSCs have significantly lower TGF- β (P < 0.00) compared to UC-EPCs.

Conclusion

This study highlighted on liver regeneration role of both human UC-EPCs and BM-MSCs in liver fibrosis by different signaling mechanistic.
Comparing different risk factors associated with delisting of hepatocellular carcinoma patients candidates for liver transplantation
Authors: Elkarmouty K Z , Ahmed M M B , ElKilany H H , Rasmy H S , Mohamed R S , Iskandar E E E
Published: May 2020

Background

Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide, with more than 1 million new cases diagnosed every year. Liver transplantation (LT) has been used as a curative treatment for patients with HCC. In countries where the liver allograft allocation is based on the Model for End-Stage Liver Disease (MELD) system, patients with HCC within the Milan criteria (MC) receive exception points, preventing dropout from the list.

Objective

The aim of this study is to analyse the different risk factors leading to delisting in liver transplant patients with hepatocellular carcinoma.

Methods

This study was a retrospective cohort study which had been carried out during the period between January 2017 to June 2018. During it, 48 patients were listed for LDLT at Ain Shams Center for Organ Transplantation (ASCOT) at Ain Shams Specialized Hospital till liver transplantation. By the end of this period 29 patients were delisted due to several reasons while 12 got transplanted and 7 were still on the waiting list. The study protocol was approved by the medical ethics committee of Ain Shams University.

Results

Regarding this study’s results, 25% were transplanted, 60.42% were delisted and 14.58% remained on the waiting list. 51.72% of patients in this study were delisted due to unavailability of related donor. In this center only related donors were allowed to donate as it follows Egypt’s organ donation policies, there are no organ allocation systems and deceased donor liver transplantation is illegal limiting availability of donors.

Conclusion

At the end of this study we can conclude that, age and tumour classification were independent predictors of delisting HCC patients candidates for liver transplantation.
Study of interlukin 6 (IL -6) in chronic lymphocytic leukemia patients
Authors: Hassan E A , Abdelhady E A , Hamza M T M , Abdelsamee H F , Elrazzaz M K , Hafez G H F
Published: May 2020

Background

Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. These malignant B-CLL cells represent over 99% of peripheral blood mononuclear cells (PBMCs) in CLL patients. In case of an aggressive form, the cell number may quickly double and, as a result, the disease may be fatal within a relatively short period of time .Currently several biomarkers are being used as CLL prognosticators, including: elevated protein levels (e.g. TCL-1, ZAP-70, CD38), elevated RNA levels (e.g. CLLU1, LPL, miRNAs), gene mutations (e.g.TP53, SF3B1, BIRC3, NOTCH1) and epigenetic changes. Early reports implicated IL-6 as pro-tumorigenic factor in various human tumors. IL-6 levels increased significantly in serum of CLL patients and correlated with adverse clinical features and short survival.

Aim of the work

Is to evaluate IL 6 level in patients with CLL at time of presentation and 6 months after chemotherapy and to study its relevance to disease prognosis.

Patients and Methods

This Study is a cross sectional study that was conducted on 55 patients newly diagnosed with chronic lymphocytic leukemia (CLL) in Clinical Hematology Unit in Ain-Shams University Hospitals in Cairo, Egypt. The control group included 50 healthy control subjects.

Result

The initial serum IL 6 level in the patient group (pre-treatment) ranged from 36-91pg/mL (median 57), and in the control group it ranged from 1-2 pg/mL (median 1).The initial serum IL 6 level in patient group (pre-treatment) range from 36-91 pg/mL (median 57), and in patient group (post treatment) range from 1-32 pg/mL (median 2).There are positive correlations between IL6 level and with WBC, B2 microglobulin, LDH, ESR, B symptoms, Uric Acid, BM Aspirate (% of lymphocytes)and Binet and Rai staging system.

Conclusion

Serum IL 6 is a useful poor prognostic marker in newly diagnosed CLL patients, its prognostic value goes with the other known prognostic markers as the lymphocytic count, ESR and LDH.

Abbreviations: CLL (chronic lymphocytic leukaemia); IL-6 (interleukin 6).
Caudal block versus penile block for postoperative analgesia in children undergoing hypospadias repair
Authors: Salama H G , Elsersi M H , Shabana T S , Mahanna J M
Published: May 2020

Background

Hypospadias repair is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provides safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery.

Aim of the Work

The aim of this work is to evaluate the success rate and the effectiveness of penile block for hypospadias repair in pediatric patients in comparison with caudal block.

Patients and Methods

This prospective randomized study was conducted in Ain Shams University Hospitals; Pediatric Surgery Unit. It included 80 ASA I or II patients undergoing hypospadias (distal penile and mid penile) repair. They were divided into two groups: Group P: Group P penile block (n = 40) received dorsal penile nerve block by using the subpubic approach technique. Group C: Group C caudal block (n = 40) received caudal epidural block using a 22-G needle in the lateral decubitus position.

Results

There was no statistically significant difference between two groups regarding haemodynamics including MBP (P < 0.05) and HR (P < 0.05). FLACC pain scores were significantly lower in group C compared with group P (P< 0.01). Also, the time to first need for analgesia was significantly lower in group C compared with group P (P< 0.001) .The total rescue analgesic requirement was also significantly lower (P< 0.001) in group C compared with group P.Postoperative time of ambulation was also significantly lower (P< 0.05) in group P compared with group C.

Conclusion

the current study revealed that caudal block provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and prolonged time of ambulation as compared with penile block in pediatric patients undergoing hypospadias repair.
Non-alcoholic Fatty Liver Disease and ECG changes in Egyptian Patients
Authors: Alsawaby A S , Elfeky R A , Mohamed A E , Abdelaziz H , Saleh S A , Mohammed H G , Montasser I F , Abdelbary M H
Published: May 2020

Background

interactions between the heart and the liver have been described. The presence and severity of non-alcoholic fatty liver disease (NAFLD) was found to be associated with increased QTc interval and subclinical cardiac abnormalities.

Aim of the work is to evaluate the electrocardiographic (ECG) and echocardiographic changes in patients with NAFLD and its correlation with disease severity.

Patients and Methods

this study was conducted on 50 NAFLD patients and 50 controls. Clinical, laboratory, ultrasonographic examinations were done for all included subjects together with liver biopsies. ECG and ECHO were also performed.

Results

longer corrected QT was found in the NAFLD group in comparison to controls (406.6±26.8 msec and 380.0±24.5 msec respectively). Significant correlation between QTc and liver size, grade of steatosis and NAFLD activity score (NAS) was found. 16% and 8% of NAFLD patients had diastolic and valvular dysfunctions respectively.

Conclusion

NAFLD is associated with significant QTc prolongation and structural heart changes with significant correlation between QTc and disease severity.
Cytokeratin 18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients
Authors: Maher M , Abdelaziz H , yossif T , Ossama M
Published: May 2020

Background

Non-alcoholic fatty liver disease (NAFLD) is one of the types of fatty liver which occurs when exceeive fat is deposited in the liver due to causes other than excessive alcohol use, NAFLD is subdivided into non alcoholic fatty liver (NAFLD) and nonalcoholic steatohepatitis (NASH). In NAFLD, hepatic steatosis is present without evidence of significant inflammation, whereas in NASH, hepatic steatosis is associated with hepatic inflammation

Aims

To evaluate the role of CK-18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients.

Patients and Methods

60 subjects were divided into 2 groups: group I: including 30 patients with NAFLD, group II: including 30 matched healthy controls Diagnosis of NASH and its discrimination from NAFL was done by fibroscan. CK-18 level in plasma was measured for all subjects using ELISA.

Results

CK-18 was significantly elevated in patients of group I in comparison to group II, with mean ± SD: 460 ± 279, 167 ± 56 and 149 ± 57, respectively, and P value: 0.001. with mean ±SD: 59.6± 28, when compared with control group (with 23±8) P value < 0.001. ROC curve between Cases and Control regard CK18 with Area Under the Curve (AUC): 0.925. Cutoff > 30 ug/l With Sensitivity: 86.67% & Specificity: 83.33%. Ck-18 was found to correlate with steatosis and fibrosis assessed by fibroscan with P value< 0.001.

Conclusion

Measurement of serum cytokeratin 18 fragment levels (CK18) correlate with the Fibroscan (Transient Elastograph) as a non invasive tests in diagnosis & prognosis of non alcoholic fatty liver diseases (NAFLD).