bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical trial to compare between different dressing methods on split thickness graft donor site (conventional method VS Ca alginate Vs Hydrocolloid sheet)
Authors: Tantawy H S , Kotb M O , Gerges W B , Shihata M M A
Published: May 2020

Background

According WHO Egypt has high incidence in RTA and burn. Controversy between studies and reviews on the best dressing on donor site, while evidence support the use of moist wound dressings other centers believe that the impregnated gauze is cost effective.

Objective

Comparison between 3 types of dressings: The Conventional method (Vaseline gauze), Calcium alginate and Hydrocolloid sheets to determine which donor-site dressings are associated with the best outcomes for faster healing rate, less Pain, decreased Infection rate, healing quality and cost-effectiveness.

Patients and Methods

This study was conducted on 60 patients 35 males (58.33%) and 25 females (41.67%) in Ahmed Maher Teaching hospital divided into 20 patients in each, the conventional by Vaseline gauze group, the hydrocolloid using group and the Ca alginate group.

Results

The hydrocolloid showed highly significant overall results in faster epithilization and healing rate with mean 9.35 days ± 1.8 days and significant pain reduction post operatively and comfort during dressings and it was satisfactory in the reduction in change frequency as most patients healed between 7 – 10 days and in most cases the requirement for dressing change was every 5 days.

Conclusion

Modern wound dressings should become the standard of care in Egyptian burn centers and hydrocolloid is advised when multiple reharvesting for huge skin defects and increase satisfaction with considerable cost effectiveness. Vaseline gauze showed the worst results, but cost effectiveness by direct method is doubted if compared by the indirect and global cost of analgesics, hospital stay and medical stuff burden of dressing frequency.
Evaluation of growth monitoring care process for stunted under-five aged children in two primary health care units in Cairo- Egypt
Authors: Haidar A R , Elawady M A , Ez-elarab H S , Albagoury L S
Published: May 2020

Growth monitoring is an essential element of child health care. Children’s healthy growth and development, and detection of variations from typical growth can be confirmed by proper growth monitoring.

Objective

This study aimed to evaluate detection and referral processes of cases of stunting among a sample of children aged less than 5 years attending maternal and child Healthcare centers in Cairo.

Methods

a quality of performance study carried out to observe children aged less than 5 years attending two primary healthcare centers during their growth monitoring process to assess the quality of documentation (14 items), body measurements (Anthropometric Measurements – 11 items for height and 8 for weight measurements), plotting (3 items), interpretation (4 items) and referral of detected cases (2 items) using observational checklist. Interviewing questionnaire for healthcare workers to assess their knowledge and skills in the process of detection of stunting.

Results

Observed growth monitoring process was undertaken for 300 children, 51% boys and 49% girls, 44% were breastfed. Out of the sample 27 (9.3%) were < -2 Z-score height for age, 5 (1.7%) were < -2 Z-score weight for age, 5 (1.7%) were < -2 Z-score weight for height and 4 (1.3%) were < -2 Z-score body mass index for age. By Observational checklist results for growth monitoring process for documentation (28.5%) of items were not done, (53.7%) were good done and (17.8%) were satisfactory done. For measuring height (9%) of items were not done, (45.5%) were poor done, (9%) were satisfactory done and (36.5%) were good done. For measuring weight (25%) of items were not done, (6.2%) were poorly done, (12.5%) were satisfactory done and (56.3%) were good done. For plotting on growth chart (66.7%) of items were not done and (33.3%) were good done. For Interpretation of the growth pattern and referral (100%) of items not done.

Conclusion

Growth monitoring shows areas in need for improvement as the detection process including documentation and follow standardized anthropometric measurements, up-to-date and periodic staff training. Developing formal and well organized referral of detected stunted is a mandate.
Role of multidetector CT Coronary Angiography in Assessment of the prevalence and plaque composition between dyslipidemic and non dyslipidemic patients
Authors: Elsaed S A , Allam K E , Geneidi E A S , Abdelrahman A S
Published: May 2020

Purpose

To highlight the role of multislice CT coronary angiography with its new applications such as reformatted images, and high resolution imaging, regarding coronary plaque composition and prevalence in dyslipidemic and non dyslipidemic patients

Methods

The study included 30 patients, 15 non dyslipidemic and 15 dyslipidemic patients. Each patient included in the study was subjected to full history taking, reviewing medical sheet. CTCA was performed for all patients followed by analysis of the plaque composition and percent stenosis using the axial images and multiplanar reconstruction.

Results

It was found that dyslipidemic patients had more plaque burden than non dyslipidemic. The dyslipidemic patients were more liable for multiple and soft plaques, mainly appreciated at the distal segment of the coronary arteries while non dyslipidemic were more liable for single and calcific/mixed plaques. Thus, may encourage the clinician to use lipid lower drugs as primary or secondary intervention for CAD.
The pattern of hysterosalpingographic findings in Egyptian females being investigated for infertility
Authors: Hasan R M M , Salama A M M , Abdelsamad A M
Published: May 2020

Background

Infertility is a complex disorder with significant medical, psychological and economic problems.

Objective

To determine the structural and pathological pattern of the fallopian tubes and uterus on hysterosalpingography (HSG) examination in cases of female infertility.

Methods

A retrospective study, conducted at ain Shams University hospitals on female patients complaining of infertility, the patients were investigated using hysterosalpingogram in the period between June 2017 till end of May 2018.

Results

A total of 484 patients were evaluated with the age ranging from 17 to 48 years old, whether the mean was 30.29 years (SD ± 6.43). Of these, 185 cases were complaining of primary infertility and 299 cases were secondary infertility constituting (38.2 %) and (61.8%) respectively. (50.6 %) of the cases had abnormalities on the HSG& Normal pattern was found in the rest (49.4%) cases, tubal factor as a cause of infertility was the most salient feature among the abnormal HSG patterns. Unilateral proximal tubal block was the most common tubal abnormality, whether mullerian anomalies was the most common uterine abnormality encountered.

Conclusion

Hysterosalpingogram is still widely used because it is cheap, readily available, non invasive, easy to interpret and has the ability to demonstrate dynamic free contrast spillage. It is usually the first line of imaging evaluation of the fallopian tubes in infertility, especially in developing countries such as ours. This study reveals that there was a high incidence of tubal disease in the women presenting with infertility, this was commonly as a result of infection and inflammatory process.
MR diffusion imaging in mediastinal masses the differentiation between benign and malignant lesions
Authors: Ibrahim T E M , Mohamed Y A , Elia R Z , Hussien R S
Published: May 2020

Purpose

Diffusion-weighted imaging is a fundamental tool integrated in MR protocols useful in differentiating benign from malignant mediastinal masses, assessing mediastinal lymphadenopathy and investigating central bronchogenic carcinoma. This method is an excellent alternative to CT or PET/CT in the investigation of mediastinal masses. Current applications of diffusion MRI in malignancies include monitoring the treatment response and detecting recurrent cancer.

Aim of the Work

This study aims to assess the value of using MRI diffusion in differentiating benign and malignant mediastinal masses, differentiating central masses from post obstructive collapse and differentiating lymphoma versus sarcoidosis.

Patients and Methods

This study included 30 patients; 16 males and 14 females in the period from June 2013 to July 2014. The mean age was 49.3 ± 16.85 (range: 22–82 years). Cases were referred for MRI assessment and were approved by the ethical committee in our department. The complaints varied between dyspnea, chest pain, cough, hemoptysis, fatigue and loss of weight. A superconducting 1.5 T MRI machine with a four-channel body phased-array coil was used for the examination. Biopsy and histopathological assessment was done after that.

Results

MRI examination with diffusion imaging was able to differentiate between benign and malignant mediastinal and hilar lesion confirmed by the biopsy and histopathology.

Conclusion

MRI with diffusion weighted images can detect and stage lung cancer, differentiate benign from malignant mediastinal masses and differentiate lymphoma from sarcoidosis in mediastinal/hilar lymphadenopathy.
Quantitative liver MR imaging with DWI sequence and Normalized ADC in diagnosis and staging of hepatitis C virus liver fibrosis and cirrhosis, a comparative study with transient elastography (Fibroscan) in egyptian patients
Authors: Rashad H S M , Abdelhafez E M , Elia R Z , Barakat E M , Rady A E
Published: May 2020

Purpose

To evaluate the diagnostic efficacy of quantitative liver MR imaging using diffusion-weighted imaging (DWI) and normalized apparent diffusion coefficient (ADC) in diagnosis and staging of liver fibrosis and cirrhosis in egyptian patients with hepatitis C virus (HCV) infection and compare the results with transient elastography (FibroScan).

Materials and Methods

Twenty-five patients known to have hepatitis C virus were enrolled after fulfilling inclusion and exclusion criteria.. Quantification of liver, spleen and muscle ADC values was done using MRI DWI sequences using 4 different b-values (0, 200, 400, 800). Normalized ADC was calculated as the ratio of liver ADC to spleen ADC.. Post processing was performed using 3D synapse ADC viewer Tool.

Results

Liver ADC failed to distinguish different stages of fibrosis, except between stages 2 and 3 (p = 0.016). Normalized liver ADC distinguished between individual groups of fibrosis , with significant differences between mild stages (stage 0/1) and sever stages of fibrosis (stages 3) and between stages 0/1 and cirrhosis (stage 4). There were significant differences between stages 0–2 and 3–4 using normalized liver ADC. There was a statistically significant moderate correlation between fibrosis stage and normalized liver ADC (r = −0.403; p = 0.009). ROC analysis revealed higher performance using normalized liver ADC compared with liver ADC, with higher AUC, sensitivity, and specificity for detection of cirrhosis (stage 0 vs 4 and stages 0–3 vs 4), moderate-to-advanced fibrosis (stages 2–4), and advanced fibrosis and cirrhosis (stages 3–4), reaching significance for all comparisons except for diagnosis of stage 4 (cirrhosis).

Conclusion

Our results suggest that normalizing liver ADC with spleen ADC improves diagnostic accuracy for detection of liver fibrosis and cirrhosis in egyptian population when using breath-hold diffusion-weighted imaging.
Role of PET/CT in detection of post-Thyroidectomy recurrence in differentiated cancer thyroid patients with negative radio-isotope iodine scan & elevated serum thyroglobulin level
Authors: Mohamed A M , Ibrahim A M , Ahmed A Y , Khalifa A A
Published: May 2020

Aim of the Work

To study of the role of PET/CT in in detection of post-thyroidectomy recurrence in differentiated cancer thyroid patients having negative radio-isotope iodine scan & high serum thyroglobulin level.

Materials and Methods

The study incorporated 20 patients with previous history of differentiated cancer thyroid. All patients performed Serum Thyroglobulin level Estimation & entire body scan I-131 (WBS) examination & PET/CT study alluded from oncology specialist to Radiology Department. All patients in the study were subjected to history taking &revising the medical sheet.

Results

PET/CT results will be compared with iodine radio-isotope scan & serum thyroglobulin level and statistical analysis of the collected data will be performed to determine the diagnostic value of the PET/CT in detection of local recurrence or distant metastasis.
Role of MRI Arthrography Compared to Conventional MRI in Assessment of Shoulder Joint Disorders
Authors: Nassef M A , Abdulrahim S A A , Eldesouki D A A M
Published: May 2020

Glenohumeral joint instability is extremely common. With regard to primary anterior shoulder dislocations, the incidence is between 8.2 and 23.9 per 100 000 person-years, with an estimated prevalence of 1.7%. Many imaging methods, including arthrography, CT arthrography, MR arthrography, have been used to image the glenoid labrum and the associated structures of the capsular mechanism. The aim of the study is to prove MR arthrography is the preferred imaging technique for the investigation of patients with shoulder instability. MR arthrography reliably shows subtle lesions of the labroligamentous complex, providing information essential to the surgeon concerning the surgery or arthroscopic repair .Thirty Patients with clinically evident or suspected shoulder impingemint or glenohumeral instability.of both sexes were included , conventional MRI was performed for all patients followed by CT guided intraarticular contrast injection then MRI Arthrography images taken within thirty minutes. Data were collected, revised, coded and entered to the Statistical Package for Social Science (IBM SPSS) version 20.
Utility of diffusion weighted mr in diffrentation between benign and malgnant breast lesions
Authors: Rady A E E , Sakr H M , Abdelkhalie Y I , Sadek A S M
Published: May 2020

Purpose of this Study is

To evaluate the role of DWI MRI in the differentiation between benign and malignant breast lesions.

Methods

The study included 40 patients all of them were females with positive breast lesion detected by ultrasound or mammography (between 25 and 66 years of age) referred from surgery and oncology departments. Each patient included in the study was subjected to full history taking, mammography, ultrasonography and conventional MRI sequences and Diffusion Weighted imaging and ADC value measurement. Technique was performed using a standard 1.5 Tesla unit (Acheiva, Philips).

Results

The study showed significant results were obtained between ADC values of benign and malignant lesions (p < 0.001).

Conclusion

According to the results of this study we concluded that the addition of DW-MRI and ADC value measurements to the conventional MRI of the breast increased the accuracy of diagnosis and characterization of different breast masses. Also, the use of DW-MRI with ADC value measurements was found to be a valuable quantitative analysis.

Keywords

Breast masses– MRI – Diffusion weighted imaging Apparent diffusion coefficient.
Role of hepatic colour duplex ultrasound in assessment of non alcoholic fatty liver disease-nafld
Authors: Botrous S M , Hafez E M A , Sabry D A
Published: May 2020

Background

Gray-scale ultrasonography (US) is an initial, easy to use and widely available imaging modality for NAFLD, the presence of fat infiltration in the liver in the absence of excessive alcohol consumption and other causes of liver disease, is the most common cause of fatty liver, with a prevalence as high as 15-25% in many populations.

Objective

to determine the effect of obesity and NAFLD on the Doppler waveform pattern of the liver vascularity.

Methods

A case control study, conducted at Ain Shams University in the period between july and December 2018 . In both groups, liver span & subcutaneous fat was measured by ultrasonographic examination. Hepatic vein waveform pattern & portal vein mean flow velocity were assessed & hepatic artery resistance index was measured by duplex Doppler ultrasonography examination.

Results

Our study included 50 patients , 20 were control & 30 were cases.. The mean age of cases was 45.30 ± 10.15 SD & the mean age of control was 32.70 ± 10.95 SD rendering the mean age of cases & control of high statistical significance (p value=0.000). The Subcutaneous fat showed high significant statistical difference between cases & control groups with mean subcutaneous fat in control =0.75 ± 0.14 SD & mean subcutaneous fat in cases= 1.23 ± 0.42 SD with p –value = 0.000. The liver span showed high significant statistical difference between cases & control groups with mean in control =15.11 ± 0.85 SD & mean liver span in cases= 17.46 ± 1.67SD ( p value = 0.000). Hepatic vein wave pattern was normal in all 20 control (100%). In the 30 cases,the Hepatic vein wave pattern was triphasic in 12 patients (40%) & biphasic or monophasic In 18 patients (60%) with high statistical significance (p-value =0.000). There was negative correlation between the hepatic vein velocity & BMI with ( p value=0.0032). There was no statistically significant difference between cases & control as regards all Doppler indices including the Hepatic artery RI(resistive index), Hepatic artery PSV(peak systolic velocity), Portal vein velocity(maximum & minimum)& hepatic vein velocity (maximum velocity) where the p value was more than 0.05.

Conclusion

Patients with NAFLD have a high rate of abnormal hepatic vein Doppler waveform patterns ,which can be biphasic or monophasic rather than alterations in hepatic artery resistance index values by duplex Doppler ultrasonography. Also the fatty infiltration of hepatocytes can increase liver span & the subcutaneous fat.
The role of MRI in Detection and Characterization of Benign Hepatic Focal Lesions
Authors: Abdelghany A F , Abdeldayem E H , Millad S K
Published: May 2020

Background

The benign and malignant hepatic foci are a common disease in recent times. The most benign lesions are in non cirrhotic liver. The main goals of MRI liver techniques are detection and characterization of equivocal hepatic focal lesions with indeterminate results by other diagnostic modalities e.g. US or CT.

Aim of the Study

to describe the role of MRI in early detection and characterization of benign Hepatic focal lesions. Using unenhancement, contrast enhancement and diffusion weighted MR images; for better patient management plan.

Patients and Methods

This study conducted on 25 patients; four patients of them have 2 different HFL, suspicion of Hepatic focal lesions on the basis of US and/or CT. The study took place at Ain Shams University hospital.

Results

Present study revealed that maximum percentage of MRI finding in benign HFL is Hemangioma (37.93%) followed by Simple hepatic cyst (27.59%). The most common benign HFL are low signal intensity in T1 precontrast study and the most common benign HFL are High signal intensity in T2 precontrast study. Also, the most benign HFL show no restriction diffusion.

Conclusion

Benign hepatic focal lesions are frequently encountered in clinical practice and their characterization may be sometimes difficult. Magnetic resonance imaging MRI has more advantages than ultrasound, computed tomography CT in diagnosing and characterization of focal hepatic masses. With a combination of basic T1 and T2 weighted sequences, diffusion weighted imaging DWI, and use of contrast agents, most liver lesions can be adequately diagnosed.
PET-CT Imaging of Extranodal Involvement In Non Hodgkin Lymphoma
Authors: Mohammed A M , Abdelghany A F , Soliman A H , Nassar A N A
Published: May 2020

Background

Lymphoid neoplasms are broadly divided into Hodgkin disease (HD) and non-Hodgkin’s lymphoma (NHL). Non-Hodgkin lymphoma accounts for about 5% of all cases of cancer with greater predilection to disseminate to extra-nodal sites. Extranodal lymphoma describes that there is neoplastic proliferation at sites other than the expected native lymph nodes or lymphoid tissue. Lymphomas that initially appear to have the bulk of the disease at extranodal sites are described as primary extranodal lymphoma and categorized as Stage I or II. In secondary extranodal lymphoma, there is secondary involvement of the extranodal sites from primary nodal disease, which is categorized as Stage III or IV.

Aim and Objectives

To assess the added value of hybrid Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the evaluation of extranodal involvement in patients with non-Hodgkin lymphoma in comparison to contrast-enhanced CT (CECT).

Patients and Methods

All patients had Non-Hodgkin lymphoma, proved by histopathological and immunophenotyping examinations. They underwent CECT and F-18 FDG PET–CT studies.

Results

This study included 76 patients with pathologically confirmed lymphoma who underwent PET/CT study. The patients' ages ranged between 20 and 78 years old (mean age 51 ± 14.7 years). This study included 51 males and 21 females. Diffuse large B-cell lymphoma subtype had the highest prevalence 53% (40/76), whereas mucosa-associated lymphoid tissue lymphoma was the least prevalent 4%. The Spleen was the most common site as it was involved in 20 patients followed by bone and bone marrow 15 patients, lung 13, Liver 9, Nasopharynx 4, Muscular and Cutaneous Nodules 4 patients each, CNS, Adrenal, Renal and Pleural Affection 3 patients each, Tonsillar, stomach, Pancreas and Prostate 2 patients each, and finally only one patient had salivary gland, thyroid, breast, and testicular involvement. The overall sensitivity, specificity, PPV, NPV, and accuracy of PET/CT and CECT are 97%, 20%, 94.5%, 33.3%, 91, 6 % and 87.3%, 60 %, 93.9%, 10% and 87.5%, respectively.

Conclusion

Combined PET/CT using 18F-FDG is the best oncologic imaging modality at present time with indispensable role and valuable application in monitoring and management of the extranodal lymphoma. It can detect metabolically active lesions without CT structural changes and identify a viable tumor in normal size lymph nodes. PET/CT is more effective than CECT in evaluating extranodal Lymphomatous infiltration, especially in spleen, bone, and bone marrow.
Role of Uterine Artery Embolization using Embolic Microspheres in Treatment of Uterine Fibroid
Authors: Bassiouny R H , Elshimy A M S , Tawfik B S
Published: May 2020

Background

Uterine Artery Embolization (UAE) is a well-established treatment of symptomatic fibroids with clinical efficacy comparable with traditional surgical treatment. UAE is now commonly proposed as an organ preserving treatment to the population of younger women willing to conceive. It has been proven, in a large cohort of women wishing to conceive before embolization, that complete pregnancies can occur after UAE

Objectives

The study aims to assess the effect of uterine artery embolization using the different types of embolic microspheres in treatment of patients with uterine fibroid.

Patients and Methods

Type of Study: prospective study. Study Setting: At the radiology department of Ain Shams University hospitals and Ain Shams University Specialized Hospitals. Study Period: 6-12 months.

Results

High symptom severity score indicates severe symptoms and a high HRQOL score indicates a good quality of life. The mean UFS questionnaire baseline score was 70± 11.51 prior to embolization and became 45± 9.34 three months following embolization which indicates a good symptomatic response to the microspheres embolization. The mean QOL baseline score was 65± 8.58 prior to embolization and 81± 6.48 three months following embolization.

Conclusion

UAE using embolic microsphere is , an effective, minimally invasive procedure and easily one day procedure which showed competitive promising and well proved results when compared to other modalities outcomes in treating uterine fibroids such as conventional surgery. It deserves our attention to it's value and efficacy for the sake of the patient as a minimally invasive procedure providing better quality of life , using Embosphere and Embozene microspheres have the same symptomatic effect and volume reduction after three months follow up in compare with using Embosphere alone or with spherical polyvinyl alcohol particles.
Changes in renal function indices in chronic hepatitis C patients treated with sofosbuvir/daclatasvir, with or without ribavirin
Authors: Ahmed A A , Abdelrahman G M , Salaheldin M , Elkassas M
Published: May 2020

Background

Hepatitis C virus HCV infection is one of the main causes of chronic liver disease worldwide, Egypt has the highest national-level HCV prevalence in the world, Sofosbuvir/Daclatasvir (SOF/DAC) regimen widely used to treat HCV infection in Egypt.

Aim of the Study

to assess changes in renal indices during and after HCV treatment in chronic hepatitis C patients treated with sofosbuvir/daclatasvir, with or without ribavirin with normal baseline creatinine

Methods

This study was a real life data analysis which recruited a number of “509” patients who received (SOF/DAC) regimen for 12 weeks with or without ribavirin in New Cairo viral Hepatitis Treatment Center, one of the NCCVH specialized centers. According to Supreme Council and NCCVH Hepatitis C Updated Treatment Protocol included patients received either: Sofosbuvir (400mg) + Daclatasvir (60mg) for 12weeks orSofosbuvir (400mg) + Daclatasvir (60mg) + Ribavirin for 12weeks.

All data for chronic HCV patients who treated with sofosbuvir /daclatasvir, with or without ribavirin with normal baseline creatinine and achieved SVR,were compared to assess changes in renal indices during and after HCV treatment

Results

At the end of treatment, the estimated glomerular filtration rate (eGFR) level was significantly decreased and the serum creatinine( Scr) levels were significantly increased compared with baseline levels (eGFR: 91.63 ± 26.41 vs 85.71 ± 24.86, P01 < 0.001; Scr: .87 ± .20 vs.92 ± .22, P01 < 0.001and no significant improvements were observed at 24 w post-treatment (eGFR: 89.65 ± 26.14vs 91.63 ± 26.41 ,P02 = 0.029; Scr: .89 ± .24. vs 87 ± .20, P02 = 0.020. Considering the difference in liver conditions, changes in renal function indices were compared between cirrhotic patients and non-cirrhotic patients. At the end of treatment, cirrhotic patients and non-cirrhotic patients had decreased eGFR levels and increased Scr levels at 24 w post-treatment, the eGFR and Scr levels were significantly improved in non-cirrhotic patients, while no obvious improvements were observed in cirrhotic patients.

Conclusion

Although DAAs are highly effective and well tolerated, at the end of treatment we found that: The eGFR level was significantly decreased and the Scr levels were significantly increased compared with baseline levels and no significant improvements were observed at 24 w post-treatment.Both Cirrhotic patients and non-cirrhotic patients had decreased eGFR levels and increased Scr levels at 24 w post-treatment but the eGFR and Scr levels were significantly improved in non-cirrhotic patients , while no obvious improvements were observed in cirrhotic patients.
Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio as Diagnostic and Prognostic Markers for Hepatitis C Virus – Related Hepatocellular Carcinoma in Egyptian Patients
Authors: Elgindy E M , Montasser I M F , Saad W E , Ghanem M A
Published: May 2020

Background

hepatocellular carcinoma (HCC), a highly prevalent and lethal cancer, it is the sixth most common cancer and the third leading cause of cancer-related death worldwide.

Aim of the work

to evaluate the role of inflammatory markers Neutrophil lymphocyte ratio and Platelet lymphocyte ratio (NLR & PLR) as biomarkers for diagnosis of HCV related HCC.

Patients and Methods

this study was conducted in tropical medicine department, HCC clinic Ain-shams university hospitals. Our study included 174 candidates who were divided into three groups. Group A included 60 Patients with HCV-related HCC diagnosed according to American Association for the Study of Liver Diseases (AASLD) guidelines; HCC patients were subdivided into three subgroups According to BCLC

Results

group A included 114 Patients with HCV-related HCC, which was subdivided into three subgroups according to BCLC. Group 1 included 30 patients underwent Radio-frequency ablation (RF), 76.67% of them were males while 23.33% were females with mean age 57.433. Group 2 included 41 patients underwent Trans-arterial chemo-embolization (TACE), 80.49% were males while 19.51% were females with mean age 60.268. Group 3 included 43 Patients with BCLC stage C and D For best supportive care, 76.74% were males while 23.26% were females with mean age 60.372. Male to female ratio in HCC patients was 3.56:1.

Conclusion

AFP remains the gold standard marker for diagnosis of HCC. NLR and PLR has no role as early prognostic markers for HCC.
The Effects of Hyaluronic Acid in Preventing Recurrence of Urethral Stricture after Visual Internal Urethrotomy
Authors: Hasan H H G , Tolba M K A , Shalaby M M M
Published: May 2020

Background

Many urologists prefer Visual internal urethrotomy (VIU)because of its ease to perform, short hospital stay, low cost, and perceived low complication rate. They may repeat VIU several times to avoid complex urethral reconstruction, because it requires significant surgical experience. Because of its effectiveness and simplicity, VIU is the primary treatment option for urethral stricture disease. However, the recurrence rate is high and the success rate is low.

Aim of the Work

To evaluate the effect of hyaluronic acid (HA) instillation during visual internal urethrotomy (VIU) for decreasing the incidence of recurrent urethral stricture.

Patients and Methods

A total of 50 patients who were treated by Visualized internal uretherotomy for urethral stricture between February 2017 and January 2019 were invited to participate in the present study. This study is a multicenter,prospective, randomized controlled, single-blinded study.

Results

In this study the experimental group had a better voiding symptoms than the control group six months after the surgery,The present study showed that the instillation of hyaluronic acid into the urethra during visualized internal urethrotomy didn’t significantly reduced the recurrence of urethral stricture after the operation although the number of patients who had recurrence after hyaluronic acid instillation were less than recurrence rate in the control group. The hyaluronic acid had no observed side effects and helped to improve the pain and quality of life after the surgery.

Conclusion

The instillation of hyaluronic into the urethra during VIU reduced postoperative pain and improved voiding symptoms in the study group , but it didn’t significantly reduce the recurrence of urethral stricture after the operation. we suggest that a large-scale, randomized controlled trial be conducted in a larger number of patients with long-term follow-up .
Retroperitoneal versus Transperitoneal Laparoscopic approach for Management of Upper Ureteric Stones
Authors: Maged W A , Tolba M K A , Elfiky M E E
Published: May 2020

Background

Current options for ureteral stones include medical treatment, extracorporeal shockwave lithotripsy (SWL), and various endoscopic procedures, with the standard open ureterolithotomy being less frequently practiced nowadays. The use of laparoscopy in the management of ureteral stones was one of the earliest applications of laparoscopy in urology, the first report being made by Wickham in 1979.

Objective

To compare the laparoscopic Retroperitoneal ureterolithotomy with the Laparoscopic Transperitoneal ureterolithotomy as a better alternative to conventional open surgery to extract a large, impacted and hard stones at the proximal two thirds of the ureter.

Methods

In this study we present our experience with laparoscopic ureterolithotomy comparing both transperitoneal approach and retroperitoneal approach through a retrospective randomized comparative study that conducted on 50 patients admitted through the outpatient clinic of Urology in Ain shams University Hospitals and Nasser institute hospital. The 50 patients divided into two groups each one was 25 patients, first group was performed by the laparoscopic transperitoneal approach and the other group by the laparoscopic retroperitoneal approach Between October 2017 and October 2018.

Results

This study revealed that the length of the Hospitalization period and the duration of drainage and urethral catheter were shorter in the transperitoneal approach than in the retroperitoneal approach with statistical significance between the groups. In the present study, the mean time to oral intake was significantly shorter in the Retroperitoneal group than in the Transperitoneal group. This is due to the mobilization of the colon, dissection and retraction of the viscera, and blood and urine leak in the peritoneal cavity, causing intestinal movements and sounds to be more delayed in the LTU group. In contrast, the lost blood during the retroperitoneal procedure does not come into contact with the bowel, and if urine leakage occurs, it would be contained within the retroperitoneal space. Also we find that both approaches are safe with few complications that were significantly wider at the transperitoneal group; vascular injury didn’t occur at any of the cases with no need for blood transfusion.

Conclusion

Through our study we concluded that Laparoscopic ureterolithotomy is technically feasible and safe and both of its two approaches either transperitoneal or retroperitoneal are successful procedures with a success rate nearly the same in both techniques, but and based on our results through this study, we recommend the retroperitoneal approach for laparoscpic extraction of the ureteral stones due to the fact that it has the least operative time than the transperitoneal approach, getting rid of the all stone burden, lower rate of complications and a better postoperative recovery.
Comparative Efficacy and Safety of a Fixed-Dose Combination Therapy of Tamsulosin and Tadalafil versus Tadalafil alone for BPH Patients with Lower Urinary Tract Symptoms and Erectile Dysfunction
Authors: Shoeib M S , Elsaeed K O , Ebeid A H I H
Published: May 2020

Background

benign prostatic hyperplasia (BPH) is a disorder histologically characterized as the nonmalignant hyperplasia of prostatic cells. Most of patients with benign prostate hyperplasia present with lower urinary tract symptoms (LUTS).

Aim of the Study

to assess the efficacy and safety of fixed-dose combinations therapy of Tamsulosin & Tadalafil versus Tadalafil alone in treatment for BPH patient with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED).

Patients and Methods

this is a randomized controlled clinical study at Urology Department, Faculty of Medicine, Ain Shams University (El Demerdash Hospital) & Damanhour National Institute Hospital from 1-1-2018 till 1-9-2018. It concluded men of 45 years old or older with a history of LUTS secondary to BPH of at least 6 months were eligible for this study. Patients agreed not to use BPH medications during the research other than the study medications.

Results

the study showed that the fixed-dose combinations of Tamsulosin and Tadalafil significantly improve IPSS score and Qmax more than with Tadalafil 5 mg/day alone. Furthermore, PVRU significantly decreased with the fixed-dose combinations of Tamsulosin and Tadalafil more than with Tadalafil alone. Fixed-dose combinations of Tamsulosin 0.4 mg plus Tadalafil 5 mg were determined to be safe, efficacious, and well tolerated in the subjects investigated, which suggests the new fixed-dose combinations therapy can offer clinically relevant benefits for patients with LUTS complaints and desiring amelioration for comorbid ED complaints.

Conclusion

the study shows that the fixed- dose combination of Tamsulosin 0.4 mg/day and Tadalafil 5 mg/day are significantly superior to Tadalafil 5 mg/day alone for the treatment of BPH patients with LUTS and non-inferiority in treatment of ED Without showing any clinically significant safety issues, supporting favorable benefit-risk balance of the fixed-dose combinations of therapy for the treatment of BPH patients with LUTS and ED because of its synergistic effects, well toleration and its safety.
Retrograde Intrarenal Surgery (RIRS) vs Percutaneous Nephrolithotomy (PCNL) in Treatment of Lower Pole Renal Stone
Authors: Ragy S I , Elshorbagy A A , Alzqzouq M A
Published: May 2020

Objective

Compare the outcomes of RIRS and PCNL for the treatment of 1 to 2 cm lower calyceal renal calculi regarding the stone free rate, operative time, fluoroscopy time, hospital stay and complication rate.

Materials and Methods

Patients with a single lower calyceal stone with an evidence of a CT diameter between 1 and 2 cm were enrolled in this randomized study. Patients were randomized into two groups: group 1: underwent RIRS (20pts); group 2: underwent PCNL (20 pts). Patients were evaluated with KUB and CT after one month.

Results

Mean fluoroscopy times and Hospital stay were significantly greater in the PCNL group than in RIRS group, In the RIRS group, the stone-free rate was 85% (17/20 patients); this rate increased to 95% after a second intervention. After a single PCNL procedure, 19 of 20 (95%) patients were completely stone free and For complications, there were minimal differences in both procedures, except for hemorrhage three patients who were treated with PCNL need blood transfusion

Conclusions

PCNL and RIRS are safe and effective methods for medium-sized LP calculi. For selected patients, RIRS may represent an alternative therapy to PCNL, with acceptable efficacy and low morbidity., RIRS compared to PCNL offers the best outcome in terms of radiation exposure and hospital stay.
Prostatic Artery Embolization (The PErFecTED Technique) versus TURP for treating Benign Prostatic Hyperplasia (BPH)
Authors: Samir Y R , Aboghareeb M E , Radwan A I
Published: May 2020

Background

Benign prostatic hyperplasia (BPH) is a prevalent issue in aging men and transurethral resection of the prostate (TURP) still represents the gold standard of surgical treatment. Recently, prostatic artery embolization (PAE) was described as a new less invasive treatment alternative. Some modifications are being made to the technique presenting “The PErFecTED Technique” in order to propose better results to PAE and studies are needed to compare this novel technique to the gold standard TURP.

Aim of the Study

To compare results, safety and outcome of PAE (the PErFecTED Technique) and Bipolar TURP versus Monopolar TURP for treating LUTS due to BPH in aging males

Methods/Design

This is a single-centre, prospective, randomized, trial comparing treatment effects and adverse events among PErFecTED PAE, Bipolar TURP and Monopolar TURP in a tertiary referral centre. 60 patients who are electable for the three treatment options are randomized to a one of them. Immediate postoperative follow up of Na+ and Haemoglobin are assessed just postoperatively. 6 months later, Changes of the International Prostate Symptom Score (IPSS) and Quality Of Life (QOL) Changes in uroflowmetry, prostate size, post-void residual urine.

Discussion

The aim of the study is to compare results, safety and outcome of PAE (the PErFecTED Technique), Bipolar TURP and Monopolar TURP for treating LUTS due to BPH in aging males.

Conclusion

PErFecTED PAE may represent a good treatment option in highly selective patients, those who are complaining of LUTS due to BPH, yet they are unfit for surgery or where undergoing surgery is very risky. There is little to be lost by trying PErFecTED PAE, as it is safe, with minimal complications and a modest failure rate. Whilst it may not be a true replacement for TURP.
Early Serum Sodium Changes in Elderly Patients with Nocturia Receiving Desmopressin
Authors: Mourad M S , Abuelnaga M A , Satour A M
Published: May 2020

Background

In spite of its prevalence underestimated, nocturia is in fact an extremely common condition that has considerable impact on quality of life and health outcomes, especially in the elderly. It can be caused by a variety of factors; the pathogenesis of nocturia is complex and sometimes multifactorial, involving several organ systems.

Aim of the Work

The aim of this study is to determine early serum sodium changes in elderly patients with nocturia receiving Desmopressin.

Patients and Methods

This prospective cohort design study was conducted on 28 patients aging 55 years or more complaining of nocturia and receiving desmopressin at Ain shams university hospitals starting From February 2018 till July 2018.

Results

Desmopressin caused a significant reduction in nocturnal urine volume, nocturnal polyuria index (NPI), number of nocturnal voids and delay in the time of first void with a statistically insignificant drop in sodium level (2%) among males and a statistically significant drop in sodium level (3.1%) among females with infrequent side effects e.g., hyponatremia (7.14%) and headache (10.7%) that occurred after one week from treatment initiation.

Conclusion

The incidence of hyponatraemia can be reduced by using minimum effective dose of desmopressin. A sodium monitoring plan must be proposed with baseline sodium must be ≥ 135 mmol/L (especially in elderly), with additional monitoring at week 2,3 and 4 for those at high risk of developing hyponatremia specially those aged ≥ 65 years or receiving concomitant medication inducing hyponatraemia. This monitoring plan can help to prevent some high risk patients from developing hyponatraemia.
Enhanced Recovery after Surgery (ERAS) Protocols versus Standard Care in Perioperative Management of Radical Cystectomy with Urinary Diversion
Authors: Shoeib M S , Yassin M M , Tolba M K , Mohamed A M M
Published: May 2020

Background

Bladder cancer is the ninth most common cancer worldwide, with an estimated 430 000 new cases in 2012. Bladder cancer has more than 130,000 deaths per year worldwide, with an estimated male: female ratio of 3.8:1.0.

Aim of the Work

to examine the current evidence for ERAS in preoperative, intraoperative and post-operative setting of care for RC patients, to propose ERAS evidence-based protocol for patients undergoing Radical Cystectomy in Egypt environment and to compare the effectiveness of ERAS versus standard care on perioperative outcomes after cystectomy including Length of Hospital Stay,bowel movement, Complications and Readmission Rate in 30Day.

Patients and Methods

This is a prospective randomized comparative study done at the urology departments of Ain Shams University and Nasser institute for research and treatment in 2018. Forty patients were included in this study who were indicated For Radical Cystectomy. They were recruited and randomized in two groups: Group A: where they followed enhanced recovery after Surgery protocols and Group B: where they followed the the classic pre-operative and post-operative protocols.

Results

We finished to that Enhanced recovery after surgery (ERAS) protocols in radical cystectomy is safe and not associated with any increase in intraoperative and post-operative complications compared to standard protocol. It is associated with reductions in the length of hospital stay, time to return to full diet, time to flatulence, time for defecation and pain post-operative. There is no difference in 30 day readmission rate between ERAS and Standard Care. Our prospective randomized controlled trial covers most of the items recommended for ERAS excluding the use of a laparoscopic or robotic approach, Audit, and use of alvimopan, a peripherally acting μ-opioid antagonist, which is not available in Egypt. Our study reveals many issues that need to be considered when designing a larger more powered study.

Conclusion

Enhanced recovery after surgery (ERAS) protocols in radical cystectomy is safe and not associated with any increase in intraoperative and post-operative complications compared to standard protocol. It is associated with reductions in the length of hospital stay, time to return to full diet, time to flatulence, time for defecation and pain post operative. There is no difference in 30 day readmission rate between ERAS and Standard Care.
Assessment Study of Glans Approximation (Wingless Glanuloplasty) for Repair of Distal Penile Hypospadias (Pilot Study)
Authors: Mourad M S , Farouk A , Rateb M H A
Published: May 2020

Background

Hypospadias refers to a birth defect of the urethra in the male where the urinary opening is not at the correct location on the head of the penis. It is the second most common birth abnormality in boys, affecting approximately 1 of every 300.

Objective

To evaluate the outcomes, safety, efficacy, and cosmetic appearance of glans approximation (wingless glanuloplasty) in treatment of distal penile hypospadias (glanular & coronal).

Patients and Methods

The study was Controlled, Prospective pilot study, conducted on (10) patients with penile hypospadias with different degree (coronal & DPH). This study was done at El- Demerdash University Hospital and take one year. The patients were who fulfill the following inclusion criteria.

Results

As regards the complication rate in our study, we found that these complications similar between the two groups, with non significant differences. Regarding coronal group, complications were detected in 5 out of the 7 cases (2 cases developed infection, and one case with hematoma, catheter blockage or fistula). Regarding DPH group, complications were found in 2 out of the 3 cases (one case for each of hematoma and fistula). None of the studied cases in the two groups developed catheter slippage, meatal stenosis or glans dehiscence.

Conclusion

Approximated glanuloplasty has many advantages, lower operative time, lower blood loss, no need for tourniquet and is a simple procedure for the hypospadiologist.
Subcapsular renal hematoma in patients underwent upper ureteroscopic lithotripsy
Authors: Kotb Y M , Abdelfattah M K , Saleh I M
Published: May 2020

Objective

to demonstrate the risk factors of developing subcapsular renal hematoma ( SRH) in patients who underwent ureteroscopic lithotripsy for upper ureteric stones.

Materials and Methods

In a randomized controlled trial, 60 patients with an upper ureteric stone underwent URS lithotripsy either by laser or pneumatic. The inclusion criteria were age above 14 years old, of both sexes with an upper ureteric stone about 2 cm in diameter. Exclusion criteria were age below 14 years old, elevated serum creatinine level, patients with coagulopathies and pregnancy. The perioperative and postoperative outcomes were evaluated and postoperative pelvi-abdominal CT with intravenous contrast was done to detect if a subcapsular hematoma has been developed.

Results

There is no significant association between the formation of subcapsular renal hematoma and degree of hydronephrosis, chronic kidney disease (CKD), body mass index (BMI), diabetes mellitus (DM), hypertension (HTN) and preoperative bacteriuria as risk factors.

Conclusions

Subcapsular hematoma post-ureteroscopic lithotripsy (URSL) for impacted upper ureteric stones is a rare but potentially serious complication. A high index of suspicion is needed when patients present with significant loin pain and fever after ureteroscopic lithotripsy for obstructing proximal ureteral stones with thin renal cortices. Stone size, degree of hydronephrosis, operation duration, and perfusion pressure of hydraulic irrigation were associated with an increased risk of SRH formation. Management of post-URSL subcapsular hematomas needs to be customized for each patient.