bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Efficacy of Daylight Photodynamic Therapy in Treatment of Primary Palmar Hyperhidrosis
Authors: El-Rahim Abdallah Marwa Abd , Soltan Marwa Yassin , Shoukry Engy Albert
Published: November 2024

Background

Hyperhidorsis is a condition in which sweat production exceeds that is needed for thermoregulation, and can affect the hands, feet, axilla, face, back, groin, and legs. It is a disabling condition that affect, both children and adults, with in a rate of 1-3% and onset usually during childhood or adolescence. Although not a dangerous condition, hyperhidrosis can cause social and occupational impairment and emotional distress and facilitate the development of secondary morbidity.

Objective

To evaluate the efficacy and tolerability of photodynamic therapy (PDT) using daylight for treatment primary palmar hyperhidrosis.

Patients and Methods

We studied the effect of PDT on 20 patients with primary palmar hyperhidrosis. The night before every session the patient used a cream containing (10 % urea, 5% salicylic acid) under occlusion as an emollient and to facilitate the photosensitizer skin delivery in the next morning. Application of methylene blue 2% for the right palm as a photosensitizer and hematoxylin stain as a placebo for the other palm for one hour under occlusion as an incubation period. After one hour of incubation, exposure to daylight for one hour from 11 am to 12 pm. The patients were advised to continue using the moisturizing cream containing (urea 10%, salicylic acid 5%) daily in between sessions but on the night before the session, the patient was asked to keep it under occlusion the whole night. The treatment sessions were done twice weekly for a maximum of 8 sessions. A starch-iodine test was done before each session.

Results

We found that we could reach good response for treatment of primary palmar hyperhidrosis with reduction of the hyperhidrosis scores after eight sessions of treatment with PDT using MB as the photosensitizer and the daylight as the light source while hematoxylin use, as a placebo, showed almost no effect. The effect was maintained at least for two months after the last treatment session. The side effects were mostly limited to transient palm staining by the photosensitizer.

Conclusion

Daylight photodynamic therapy is an effective, safe method for managing primary palmar hyperhidrosis.
Assessment of Topical PUVA in Acral Vitiligo
Authors: Rahim Abd Allah Marwa Abdul , Elfattah Afify Ahmed Abd , ElSayed ElSawy Hana Mohammed
Published: November 2024

Acral vitiligo is a resistant subtype of vitiligo that does not respond easily to any treatment modalities. Topical psoralen plus ultraviolet A (topical PUVA) therapy is an option in case of localized dermatosis such as acral vitiligo. Ultraviolet A therapy can penetrate the dermis of the skin. This study objective was to evaluate the effect of topical PUVA in acral vitiligo.

Methods

Patients in this prospective randomized-controlled comparative clinical trial were divided in to two groups, first group received narrow band ultraviolet B (NB-UVB) and topical PUVA at the same time, second group were already on NB-UVB and topical PUVA were added. Patients received 36 sessions of phototherapy over a period of 16 weeks. Every patient was evaluated monthly using point counting.

Results

No statistically significant difference was found between both groups regarding response.

Conclusion

Topical PUVA is of limited use in acral vitiligo.
Efficacy of Oral Ivermectin in Treatment of Rosacea
Authors: El Din Abdel Hamid Kariman Salah , Sharara Manal , Emam Adel
Published: November 2024

Introduction

Rosacea is a chronic inflammatory dermatosis involving certain facial areas such as chin, nose, forehead, and cheeks. Several therapies were reported in the treatment of rosacea but with variable results.

Aim of the Study

To evaluate the efficacy, safety, adverse effects, relapse rate and patient’s satisfaction of single 250μg/kg dose of oral ivermectin in the treatment of rosacea.

Patients and Methods

This clinical trial included 45 rosacea patients who were treated with single 250μg/kg dose of oral ivermectin, then patients were followed-up every 4 weeks for 3 months. Assessment of treatment response was performed using 2 digital photographs before receiving ivermectin and 3 months later. Two Standardized skin surface biopsies (SSSB1&2) were done before receiving ivermectin and 3 months later.

Results

Ivermectin treatment revealed significant effect in included patients as 15 patients showed clear effect of rosacea after treatment. This was consistent with Demodex mites count that showed significant decrease after treatment compared to before treatment. There was a significant relation between patients’ satisfaction and demodex mite count after treatment

Conclusion

Oral ivermectin showed significant clearing of rosacea in included patients which was reflected on patients’ satisfaction. This effect can be attributed to significant reduction in demodex mite count in treated patients.
Correlation of Nail Capillary Morphology with Metabolic Syndrome and Disease Severity in Psoriatic Patients
Authors: Khafagy Naziha Hafez , EL-Khateeb Ekramy Ahmed , Aidaros Mohamed Aly
Published: November 2024

Background

Capillaroscopy is a non-invasive technique which allows direct, in vivo imaging of skin microcirculation to detect microvascular abnormalities. An important association of psoriasis is metabolic syndrome, with a prevalence of 40% in psoriatic patients. Metabolic syndrome is a multiplex risk factor that arises from insulin resistance accompanying abnormal adipose deposition and function. Patients with metabolic syndrome have an increased risk for cardiovascular diseases and atherosclerosis.

Aim of the Work

Describe the morphology, frequency and extent of nailfold capillary changes in psoriatic patients and identify patients’ characteristics possibly associated with such changes. Study if nail capillaroscopy can detect early endothelial dysfunction, occurring in psoriasis patients with metabolic syndrome, at the level of the dermal capillary microvasculature.

Settings and Design

cross-sectional study

Materials and Methods

Sixty five psoriasis patients were divided into two groups according to the presence or absence of metabolic syndrome. Naill capillaroscopy was done and compared between both groups.

Results

Psoriatic patients with metabolic syndrome showed significant differences in nail capillarascopy findings compared to those without metabolic syndrome, reflecting the greater endothelial dysfunction.

Conclusion

nail capillaroscopy can be a very important tool in detecting early endothelial dysfunction in psoriatic patients manifested by edema and tortuous capillaries. Moreover, it can reflect the degree of vascular compromise allowing proper identification of patients at high risk for cardiovascular events, which warrants aggressive early treatment
Epidemiological and Trichoscopic Study of Patchy Scalp Alopecia in Children in Delta Egypt
Authors: El-Samahy May , Fathy Ghada , Elmoazen Mona Abd Elsaid Ali
Published: November 2024

Background

Alopecia represents a distressing problem among children and has a severe psychological impact on the affected patients and their parents.

Objective

To investigate the clinical presentations of patchy hair loss and analysis of their prevalence and trichoscope features in children in delta Egypt.

Methods

The study was done on 374 patients aged from 0-18 years (231 males, 143 females) with patchy hair loss who were subjected to detailed history taking, dermatological examination as regard the patch of alopecia, scalp skin, nails, teeth, in addition to trichoscopic examination. The obtained demographic and clinical data of the included patients were tabulated and statistically analyzed.

Results

Mean age 7.77 years, 231 (61.8%) male patients and 143 (38.2%) female patients. Hair loss in children in this study is largely non-cicatricial causes; specifically alopecia areata, followed by infectious causes; specifically scaly tinea capitits (141 patients). The total number of patients having non-infectious alopecia was 206 patients. Alopecia areata was present in 147 patients (39.3%), toxic alopecia (post folliculitis) (12.6%), trichotillomania (2.1%), and congenital alopecia. Male preponderance in cicatricial alopecia, toxic alopecia (post folliculitis) and infectious disease groups versus female preponderance in non-cicatricial alopecia, alopecia areata, trichotillomania, patchy traction alopecia. The age groups with the largest numbers of children were those school age children aged five to ten years representing (50.5%). Alopecia presented from rural areas represents (72.5%). Trichoscope examination have confirmed the dermatologic clinical diagnosis of patchy alopecia in 368 patients.

Conclusion

The largest number of children presenting with patchy alopecia in Delta Egypt were those of school age children aged five to ten years, living in rural areas. Hair loss in children is largely due to alopecia areata followed by tinea capitits. Detection of specific trichoscopic features of each disease is mandatory for the accurate diagnosis and proper differentiation of -sometimes- confusing cases of hair and scalp disorders.
Evaluation of Microneedling, Platelet-Rich Plasma, and Combined Microneedling and Platelet-Rich Plasma in Treatment of Vitiligo
Authors: Lotfy Rania Adel , Elaal Nadia Omara Abd , Elnahas Khaled Ahmed
Published: November 2024

Background

Vitiligo is an acquired pigmentary disorder resulting from loss of melanocytes which causes depigmentation of the skin. Clinically, it is characterized by the progressive loss of melanocytes causing the appearance of well-circumscribed milky white cutaneous macules and patches.

Aim of the Work

To evaluate and compare the efficacy and safety of microneedling, platelet rich plasma (PRP) and combined PRP and microneedling for patients with stable vitiligo.

Patients and Methods

This study is randomized clinical trial. It was conducted on 225 stable vitiligo lesions. All patients were selected from the dermatology outpatient vitiligo clinic of Ain Shams University hospital from November 2020 to May 2022. All subjects who participated in this study gave written informed consents. The study was approved by the research ethical committee of Ain Shams University and fulfilled all the ethical aspects required in human research.

Results

A significant reduction was demonstrated through vitiligo analysis by computer-assisted grid (VACAG) in microneedling group only than other. There was no or minimal side effects in microneedling group. Regardless of the modalities, better improvement was seen in the neck followed by the trunk then lower limbs and the least improvement was in the upper limp.

Conclusion

according to our study, microneedling achieved superior repigmentation than combined PRP and microneedling. However, PRP alone showed poor improvement. Microneedling could be used safely and effectively in treatment of refractory NSV.
Intralesional Quadrivalent Human Papilloma Virus Vaccine Antigen Injection in the Treatment of Genital Warts: Clinical Evaluation and Effect on Serum and Tissue Interferon Gamma
Authors: Mohamed Salem Samar Abdallah , Elfattah Afify Ahmed Abd , Elhady Ahmed Walid Abd , Awad Gendia Sarah Ahmed
Published: November 2024

Background

Introduction: Genital warts or condyloma accuminata - are raised lesions that develop on the skin and mucous membranes due to infection with some types of human papillomavirus (HPV). Human papillomavirus infection is one of the most common sexually transmitted diseases and it is detected at least once in the lifetime of most sexually active people. Despite various treatment options currently available, many patients experience persistent and refractory disease. We sought to evaluate the clinical effectiveness and safety profile of intralesional quadrivalent HPV vaccine (Gardasil) for the treatment of genital warts.

Aim of the Work

This study aimed to evaluate the clinical efficacy of intralesional quadrivalent Human Papilloma Virus vaccine in the treatment of genital warts and assess its impact on serum and tissue IFNγ before and after treatment.

Patients and Methods

This study included 10 female patients with ano genital warts. They received intralesional gardasil, (0.3 ml) one injection session every 2 weeks for maximum 4 injection sessions. All the patients were recruited from the Dermatology, venerology outpatient clinic at El Houd el Marsoud Hospital during the period From May 2022 to August 2022. The lab part of the study was done at clinical pathology departement at Ain Shams University. All patients were subjected to clinical examination, photographic examination at first visit before any treatment and at each follow up visit, follow-up of patients were carried out at two-week intervals for 3 months to assess clinical response and complication(s) of injection. IFN-γ was asseyed by enzyme-linked immunosorbent assay (ELISA) using human IFN-γ ELISA Kit. Then quantitative determination of human IFN-γ concentrations were recorded.

Results

There was a highly significant decrease in the median number of lesions throughout the different sessions as compared to the baseline. The median number of lesions decreased from 14 at the baseline to 12, 10, 8 and 4 at the 2nd, 3rd, 4th sessions and last visit respectively. There was significant decrease in size of the largest injected wart after each treatment session compared to base line. The median size decreased from 1.25 cm at the baseline to 0.4, 0.2, 0.2 and 0.1 cm at the 2nd, 3rd, 4th sessions and last visit respectively.

Conclusion

the current study showed that intralesional HPV vaccine (gardasil) is an effective treatment modality in treatment of genital warts. INF-γ is considerd a good indicator factor for immune mechanisms needed for wart clearance.
A Meta Analysis to Identify the Extent of Thyroidectomy in Advanced Cancer Larynx
Authors: Yassin Omar , Sabra Reda Mohamed , Marmoush Abdelrahman Tarek Saeed , Fadel Michael
Published: November 2024

Background

Laryngeal cancer is a prevalent malignancy in the head and neck region, often diagnosed at an advanced stage. The role of thyroidectomy in managing advanced laryngeal squamous cell carcinoma (LSCC) remains controversial due to inconsistent findings regarding the incidence and predictors of thyroid invasion.

Aim of the Work

This systematic review and meta-analysis aimed to assess the incidence of thyroid invasion in patients with advanced laryngeal cancer and identify risk factors for thyroid invasion to clarify the indications for thyroidectomy. The study also sought to reduce the incidence of postoperative hypothyroidism and provide guidance for individualized treatment approaches.

Patients and Methods

A comprehensive search was conducted, and six studies involving a total of 852 patients were included in the meta- analysis. Data regarding patient demographics, tumor characteristics, and incidence of thyroid invasion were extracted and analyzed.

Results

The meta-analysis revealed a mean age of 57.7 years among patients with advanced laryngeal cancer, with a male predominance of 94.6%. The overall incidence of thyroid invasion among patients undergoing total laryngectomy was 13.3%. Subglottic tumor site and T4 classification were identified as significant risk factors for thyroid invasion, while supra glottis and glottis tumor sites, as well as T3 classification, were associated with reduced risk. The odds ratio for thyroid invasion was highest for patients with T4 stage tumors.

Conclusion

Thyroidectomy during total laryngectomy should be considered for patients with subglottic tumor sites and T4 classification due to the increased risk of thyroid invasion. However, for patients with supra glottis or glottis tumor sites and T3 classification, the thyroid gland may be preserved to reduce the risk of postoperative hypothyroidism. Further research is warranted to refine the surgical indications for thyroidectomy in patients with advanced laryngeal cancer.
Piezoelectric or Conventional Osteotomy in Rhinoplasty? A Clinical and Radiological Review of Fracture Lines Outcomes
Authors: Abdalrahman Aram Othman , Shafik Amr Gouda , Ahmed Aya Yassin , Maarouf Ahmed Mahmoud , Waheeb Mina Fayez
Published: November 2024

Background

Osteotomy of the nasal bones is the most challenging and critical step in rhinoplasty. The shaping of the nasal bony structures is the key for a successful operation. Mobilization of nasal bones along with minimizing the damage of supporting tissue and avoiding the excessive narrowing are the main goals of lateral osteotomy. Various techniques for lateral osteotomies have been described in order to reach the desired aesthetic and functional results, with reduction of soft tissue damage during rhinoplasty as the major goal. Piezoelectric surgery has been presented as a new method to be used during osteotomies, which takes advantage of ultrasonic piezoelectric vibrations in order to decrease the severity of morbidities. Its ability to minimize tissue trauma and its associated morbidity, along with its cutting effectiveness, has rendered piezosurgery popular for several clinical applications in various surgical fields during the last decades.

Aim of the Study

The basic aim of our study is planned to compare the postoperative fracture line criteria of the conventional and piezoelectric osteotomy in rhinoplasty and clinical examination to assess pain, edema and ecchymosis at day 1, 3, and day 7 and will be compared between left and right side in the same case.

Patients and Methods

Interventional clinical trial study for twenty patients eligible for rhinoplasty surgery subsequently undergo median, lateral osteotomy by a conventional osteotomes on right side and with an piezoelectric device for the left side, post-operative: Axial, coronal, sagittal and 3D reformat ct scan images 0.625mm thickness was done in on nasal bone to asses fracture line, in addition: postoperative pain assessed by a ten- point scale was applied, and edema with ecchymosis was assessed by visual analogue scale.

Results

Piezoelectric device in osteotomy step was associated with less pain, edema, ecchymosis and finer fracture lines outcome in comparison to traditional technique osteotomies in rhinoplasty.

Conclusion

Traditional osteotomies cause more tissues damages as a result more pain, more edema, and ecchymosis. The fracture line in piezoelectric side was accurate and more precise with regular and finer borders.
Comparison of the Outcome between Lateral, Perimodilar and Midscalar Electrodes in Cochlear Implantation Surgery: A Systematic Review
Authors: Abdallah Mohamed Shoeib Sara Ashraf , Ibrahim Samer Ahmed , Sobhy Tamer Shoukry , Abdelmoneim Teaima Ahmed
Published: November 2024

Background

Cochlear Implants are neuroprosthetic devices that are surgically implanted receiver-stimulator package and electrode array, which when used with external sound processor can produce a sensation of sound in the recipient in people who are deaf and can't benefit from acoustic hearing aids or middle ear implants or bone conduction devices.

Objective

To compare Lateral, Midscalar, and Perimodiolar electrodes, by using a systematic review as regards: trauma to the cochlea, hearing preservation (if there is a residual hearing).

Material and Methods

The search on Google Scholar, Scopus and PubMed using the following keywords (lateral wall electrode, Midscalar electrode, perimodiolar electrode, cochlear implant, hearing preservation, cochlear trauma).

The inclusion criteria: randomized control, case control, retrospective studies, human living patients, patients with profound sensory neural hearing loss (SNHL). The quality of relevant studies was assessed by NIH quality assessment tool for the type of study (“Study Quality Assessment Tools/National Heart, Lung and Blood Institute (NHLBI),”2019). 186 articles were yielded, from which 77 articles met our criteria. After duplicates removal and restricted to English language, 67 articles were screened in title/Abstract screening, while 31 articles were screened in full text screening were included.

Results

Our study showed that hearing preservation rate with lateral electrode was 53%. Also, hearing preservation with Mid-Scala electrode was 58%. Ratio of cochlear trauma with Perimodiolar electrode was 29% (7%, 55%). Hearing preservation with Lateral electrode versus Perimodiolar electrode odds ratio was 2.20 favoring lateral electrode over Perimodiolar electrode. Hearing preservation with Lateral electrode versus Mid-Scala odd ratio was 0.79 favoring no electrode type over the other. Preserving functional residual hearing in cochlear implant is higher in lateral electrode and Midscalar than in Perimodiolar electrode.

Conclusion

Preserving functional residual hearing in cochlear implant is higher in lateral electrode and Midscalar than in Perimodiolar electrode.
Ethical Challenges Facing Healthcare Workers during Pandemics (The Learned Lessons from Covid-19)
Authors: Elsheikh Amany A , Hamed Hanan , Azab Sonya M S , Tawfik Walaa Talaat
Published: November 2024

Background

The COVID-19 pandemic has raised a host of ethical challenges. In Egypt, the circumstances were more complicated due to limited resources and lack of training to face crisis circumstances which increased the burden of the crisis on the health care workers (HCWs) all over the country. However, to date, there is no sufficient studies of the ethical issues that have been raised during COVID-19 pandemic in Egypt.

Aim

This qualitative study aims to explore the ethical challenges faced by HCWs during COVID 19 pandemic, and to discuss their related background and contributing factors in the local community.

Methods

The study included 34 HCWs working in 12 governmental health care facilities in different governorates in Egypt. Semi- structured interview questionnaire was used for data collection.

Results

The HCWs reported the following main ethical challenges that faced them throughout the provision of care for COVID-19 patients: ‘balance between their duty of care of COVID 19 patients and fear of infection’, ‘uncertainty in management of COVID 19 cases’, ‘lack of organizational support during the pandemic”, ‘rationing the scarce health care resources’, ‘social stigmatization’ and ‘psychological burden of the pandemic’.

Conclusions

The present study portrayed the main ethical issues and challenges faced by HCWs during the pandemic. It is mandatory for health care authorities to adopt appropriate measures to resolve these issues and increase their preparedness in the era of pandemic to handle any crisis in the future.
Construction of a Crucial Score to Predict the Outcome of Patients with Aluminum Phosphide Poisoning at the Poison Control Center, Ain Shams University Hospitals (PCC-ASUH)
Authors: Zaki El seaidy Fatma Fawzy , Abou Anza Rasha El Hussaini , Mohamed Rania Hussien
Published: November 2024

Introduction

Acute aluminum phosphide (ALP) poisoning has become a major toxicological challenge in developing countries due to increasing mortality rate and absence of specific antidote. The aim of this study was to “Evaluate the value of APACHE II and SOFA scores in the prediction of outcome in patients with acute ALP poisoning and construct a predictive model for ALP poisoning”.

Subjects and Methods

A prospective cross sectional study of acute ALP poisoned patients admitted to the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH) during the period from August 2022 to April 2023. Patients’ data were collected in a patient sheet and included sociodemographic data, clinical and laboratory data of APACHE II and SOFA scores, ECG evaluation and the outcome. Receiver operating characteristic (ROC) curve analysis, univariate and multivariate logistic regression analysis have been applied for data analysis.

Results

A total of 110 ALP poisoned patients were evaluated with 52 survivors and 58 non-survivors. Evaluating the predictive value of APACHE II and SOFA scores, the cut off point of APACHE II score was > 6 and AUC was 0.969 achieved 98.28% sensitivity and 86.54% specificity. The cut off point of SOFA score was > 2 and AUC was 0.983 achieved 100% sensitivity and 86.54% specificity. Univariate and multivariate regression analysis revealed that six factors were the most significant predictive factors of mortality: PO2, PH value, Glasgow coma scale (GCS), Mean arterial pressure (MAP), HCO3 level and abnormal ECG. They were valid to construct the predictive new score at cut off value of PO2 < 90% mmHg, PH < = 7.28, GCS < =12, MAP <70 mmHg, HCO3 < = 12.6 mEq/L. Scoring system was constructed of these six parameters each take a constant logistic score to give a total score of 33. The power of the predictive new score to discriminate between survivors and non-survivors at cut off > 19 was excellent (AUC: 0.999) that achieved 96.55% sensitivity and 100% specificity.

Conclusion

High sensitivity and specificity values with excellent AUC reflect the usefulness of the new predictive score and recommended its use at emergency room as it is simple, quick, easy to use and appliciable even in small hospitals to predict the outcome of acute ALP poisoned patients.
Medicolegal and Ethical Considerations in Telemedicine: Survey of Physicians’ Knowledge, Attitude and Practice, Cairo
Authors: Ramadan Magda Mokhtar , Azab Sonya M S , Salem Hanan El-Sayed , Shaaban Tasneem Ragab
Published: November 2024

Background

Telemedicine has been utilized by healthcare providers for many years, but its widespread implementation did not occur until the onset of the COVID-19 pandemic. As telemedicine has grown, the related legal and ethical issues have emerged and the concerns about its regulation is increasing.

Objective

The study aimed to assess physicians’ knowledge, attitude and practice regarding telemedicine use and its legal and ethical considerations.

Methods

An online self-administered structured questionnaire was used for data collection. The respondents were 434 physicians working in different governorates in Egypt.

Results

Most of the participants reported using telemedicine for consulting a colleague from another specialty (93.8%, 407) or the same specialty (89.4%, 388); medical education (81.1%, 352) and management of the patients (73%, 317). Knowledge and attitude scores of participants working in university hospitals were significantly greater than that for other participants. About 57% of the respondents (142 physicians) reported incidence of complications related to using telemedicine, and patient’s inability to describe his condition was reported as the most common cause of complications (97%, 244).

Conclusion

Participants’ knowledge about ethical and legal considerations related to telemedicine was sufficient. Although most of them agreed with the advantages of telemedicine, they have negative attitudes toward its use in patients’ management.
A Systematic Review of Prophylactic Central Neck Dissection on Short-Term Locoregional Recurrence in Papillary Thyroid Carcinoma in Clinically Node Negative Patients after Total Thyroidectomy
Authors: El Sayed Osama Mahmoud , Nageeb Ramy Mikhael , Ragheb Ayoub Bishoy Refaat , Abdel Hafez Ahmed Mahmoud
Published: November 2024

Background

Thyroid cancer, notably papillary thyroid carcinoma (PTC), is a global health concern, warranting effective treatment strategies. The role of prophylactic central neck dissection (PCND) in clinically node-negative cases remains a subject of debate.

Aim of the Work

This study aims to conduct a systematic review and meta-analysis to evaluate the impact of total thyroidectomy with and without PCND on locoregional recurrence (LRR) and postoperative complications in PTC patients without clinically evident nodal metastasis (cN0).

Patients and Methods

Eight relevant studies from the past decade, encompassing 11,049 participants, were included in the analysis. The study focuses on outcomes related to recurrence rates, postoperative complications, and associated factors.

Results

The analysis suggests a trend toward a reduced recurrence rate with PCND following total thyroidectomy in clinically node-negative PTC cases, although statistical significance is not reached. Postoperative complications, including permanent hypoparathyroidism and laryngeal nerve palsy, are higher in the PCND group but do not show a statistically significant difference.

Conclusion

Prophylactic central neck dissection following total thyroidectomy appears to have a potential impact on reducing recurrence in clinically node-negative PTC cases. However, the study emphasizes the need for further research to validate these findings and explores the long-term advantages of PCND in conjunction with evolving surgical techniques.
A Comparative Study Between Thyroid Surgeries and Image Guided Thyroid Ablation in Benign Thyroid Nodules – A Meta-Analysis
Authors: Mohamed Abd El-Majeed Shabaan Mohamed , El Din Abd El-Monem Aly Ayman Hossam , El-Maksoud Nouh Ahmed Ahmed Abd
Published: November 2024

Background

Nodular thyroid disease is very common in clinical practice, discovered by palpation in 3 to 7% and by ultrasound (US) in about 50% of the general population. The aim of this work to compare and evaluate the indications, efficacy, morbidity and post-operative complications of Image Guided Ablation in comparison to thyroid Surgeries

Methods

This study involved a systematic review with a meta-analysis conducted on English-language retrospective or prospective studies available on PubMed from the past 5 years. Focused on patients aged 18 years or older who had undergone either thyroid surgery or image-guided thyroid ablation. Patients were categorized into two distinct groups: Group A undergone thyroid surgery, and Group B, undergone image-guided thyroid ablation

Results

There was a significant difference regarding age and nodule volume of the two groups. with insignificant difference regarding sex and nodule parameter. Incidence of hoarseness and postoperative pain were significantly lower in the thermal ablation (TA) group than in the conventional thyroidectomy group. No heterogeneity with hoarseness while a significant heterogeneity was in postoperative pain. Incidence of hypothyroidism was not significantly lower in the TA group than in the conventional thyroidectomy group with a significant heterogeneity. In terms of symptom improvement, the difference was insignificant with low heterogeneity. TA yielded significantly better postoperative cosmetic effects than conventional thyroidectomy with no heterogeneity, also associated with a shorter hospitalization time with a significant high heterogeneity

Conclusions

TA may be a favorable alternative to thyroidectomy, offering comparable outcomes with reduced morbidity and improved cosmetic satisfaction
Evaluation of the Role of Laparoscopic Sleeve Gastrectomy and Laparoscopic One Anastomosis Gastric Bypass in the Treatment of Metabolic Syndrome
Authors: Shatla Mahmoud Gamal Mohamed , El Aziz Mohammed Magdy Abd , Fouad Helmy Ramy
Published: November 2024

Background

The dramatic rise in the prevalence of Metabolic Syndrome has become a major global health issue. The problem is complex and will require strategies at many levels to prevent, control and manage. It is well known that obesity has profound effect on tissue sensitivity to insulin and so, leads to glucose intolerance, increased in Blood Pressure and abnormalities in Lipid Profile.

Patients and Methods

We aimed to compare between laparoscopic mini-gastric bypass and laparoscopic sleeve gastrectomy regarding the efficacy of control of type 2 D.M, Hypertension and Hyperlipidemia in obese patients. It is a prospective study which was done between April 2022 – October 2022 at Ain Shams university hospitals, Cairo, Egypt. This study included 60 obese patients with type 2 D.M with one or both of the following (Hypertension and Hyperlipidemia) and divided into two groups: Group (1): (30 patients) treated by laparoscopic Sleeve gastrectomy, group (2): (30 patients) treated by laparoscopic One anastomosis- Gastric Bypass.

Results

Complete resolution of diabetes occurred in OAGB cases in 66.7% compared to 55.4% in SG cases at 6 months and cases with no remission in D.M was 0% in OAGB and 16.6% with SG. Regarding the Hypertension, in Group 1 (SG) Resolution Of Hypertension was 55%, Improvement was 25% and No Change in Hypertension Status was 20%, In Group 2 (OAGB) Resolution Of Hypertension was 62.5%, Improvement was 25% and No Change in Hypertension Status was 12.5%, with comparing the 2 groups. Regarding Hyperlipidemia. In Group 1 (SG) Resolution Of Hyperlipidemia was 48%, Improvement was 30% and No Change in Hyperlipidemia Status was 22%, In Group 2 (OAGB) Resolution Of Hyperlipidemia was 60%, Improvement was 24% and No Change in Hypertension Status was 16%.

Conclusion

Bariatric surgery (SG and OAGB) is not only weight reducing surgery but a metabolic surgery which can cure most of the metabolic syndrome and they are considered the most effective long term treatment modality for type 2 diabetes in obese patients and with comparing between SG and OAGB, our study suggests that Both procedures are highly effective in control of Diabetes, Hypertension.
Effectiveness of Anatomic Reconstruction of the Middle Hepatic Vein in Right Lobe Graft Living Donor Liver Transplantation Using Natural Portal Vein Graft and Synthetic Graft
Authors: Ibrahim Mahmoud Mohamed Elsayed , Abdo Mostafa , Abdelaal Amr , Rayan Mahmoud Talaat
Published: November 2024

Background

LDLT using the right lobe is now a standard method for adults to alleviate the problem of graft size insufficiency. Without including MHV into RLG may cause sever congestion in the segment V and VIII which leads to graft dysfunction and septic complications.

Objective

This study was conducted to evaluate the efficacy of reconstructing the MHV in RLG LDLT with native portal vein graft versus synthetic graft. Methodology: This study involved 40 patients eligible for LDLT and was divided into, group A had synthetic graft reconstruction and group B had native PV graft reconstruction, while controlling for patient characteristics.

Results

In our study, 13 cases (32.5%) of postoperative venous graft thrombosis were recorded, with a higher incidence in the synthetic graft group (45.0%) compared to the native PV graft group (20.0%). However, the trend was not statistically significant. Timing-wise, thrombosis was observed earlier in the synthetic graft group. The existence of reconstructed veins V5 and V8 was associated with a higher incidence of thrombosis in the synthetic graft group. Sepsis was also found to be a potential risk factor, but with no statistical significance.

Conclusion

In adult LDLT with right lobe graft, the native PV graft should be the first choice for MHV reconstruction. The patency rate of the native PV graft was higher than synthetic graft, especially in cases with multiple veins requiring multiple venous anastomosis, which led to a decreased incidence of thrombosis.
Comparison between Balloon & Savary Dilatation in Management of Benign Esophageal Strictures in Pediatrics
Authors: Abd El Hamid Sameh Abd El-Hay , Farouk Abadeer Ashraf , Abd El Hamid Hazem Samir , Kostangy Sos Marco Rady
Published: November 2024

Background

Esophageal strictures are seldom in children. In many countries, accidental ingestion of corrosives is a major cause of risk for stricture formation. Therefore, their management is a challenge. Safety and long-term efficacy of esophageal dilation for benign esophageal strictures has been confirmed in children.

Aim and Objectives

The aim of this study was to perform a systematic review and a meta-analysis about literature published in the period from 2010-2020 comparing between balloon & savary dilatation in benign esophageal strictures in pediatric age group.

Subjects and Methods

This systematic review and meta-analysis included 5 retrospective studies fulfilled eligibility criteria, with a total of 353 cases were included with mean age 8 years and m\f was 200\153.

Results

5 studies compare success between ballon and savary dilatation showed that there were insignificant differences between two group p-value 0.052

Conclusion

The efficacy and complication rates of bougie and dilation are similar. Considering this level of evidence 1A study, we can state that there is no significant difference between methods to recommend one over the other. However, all the confounding factors and limitations should be considered.
Utility of Intraoperative Frozen Section in Making the Decision of Lobectomy vs Total Thyroidectomy in Selected Cases of Solitary Thyroid Nodules
Authors: Ahmed Abdallah Mohamad Ahmed Mohamad , Ahmed El-Shafie Mahmoud , Omran Hesham Mohamad , Ibrahim Eman Abdel-Salam , Halim George Magdy
Published: November 2024

Background

Intraoperative frozen section (IFS) had been, historically, the main tool to determine the initial histologic diagnosis of a thyroid nodule and therefore to guide the treatment strategy. Surgery could be limited to a hemi-thyroidectomy in case of a benign nodule, while a malignant IFS diagnosis indicates a total thyroidectomy. Since the advent of preoperative fine needle aspiration (FNA), and its establishment as a mainstay in the preoperative exploration of thyroid nodules, the role of IFS in this setting has been widely questioned. The introduction in 2007 of the Bethesda system for reporting thyroid cytopathology (BSRTC) has improved FNA reporting standards and became a standard of practice.

Aim of the Work

To determine accuracy and intertest agreement of preoperative fine-needle aspiration cytology (FNAC) and intraoperative frozen-section analysis (IFS) findings in thyroid surgery, and to assess the influence of intraoperative FS findings on decision making and the utility of IFS in solitary thyroid nodules.

Patients and Methods

This study is a retrospective and prospective cohort comparative clinical study. This study was conducted at (General surgery department), Ain Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants was obtained. The period of the study between November 2020 and November 2023.

Results

The current study results Group A (n = 20) and Group B (n = 20) were assessed for demographic, baseline, hematological, biochemical, and preoperative characteristics to ensure equivalence prior to interventions. Results revealed no statistically significant differences in age distribution (p = 0.868) or gender composition (p = 0.327), indicating matched groups. Thyroid function tests (T3, T4, TSH) showed no significant variations (p = 0.820, p = 0.081, p = 0.567). Hematological and biochemical parameters (hemoglobin, creatinine, ALT, AST, INR) exhibited no significant disparities (p = 0.420, p = 0.811, p = 0.752, p = 0.571, p = 0.862). Preoperative characteristics (family history, TIRADS, nodule size, site) were well-balanced (p = 0.519, p = 0.752, p = 0.625, p = 0.321).

Conclusion

The comprehensive analysis of the clinical and pathological data comparing two groups reveals several key insights into the management and diagnostic evaluation of thyroid nodules. Firstly, there are no significant differences in baseline characteristics such as family history, TIRADS classification, nodule size, and site between the groups, ensuring a balanced comparison.
Early vs Delayed Temporal Ileostomy Closure after Low Anterior Resection (LAR) in Patients with Rectal Cancer, A Cohort Study
Authors: El-Din Abd El-Mageed Ahmed Alaa , Abd El-Maksoud Ibrahim Magid , Abd El-Gwad Mohamed Mohamed
Published: November 2024

Background

The optimal timing for ileostomy closure remains controversial, most of the surgeons are closing ileostomy after 6-8 weeks, although ileostomy closure considered a simple procedure, it can cause significant morbidity; this study aims to clarify any relation between the post-closure complications rate and the time from its creation to the repair.

Objective

To compare between early ileostomy closure within 2 weeks and delayed ileostomy closure after 6 weeks regarding post closure complications (anastmotic leak – intra abdominal collection – intestinal obstruction –SSI),operative time, post operative hospital stay and quality of life improvement.

Patients and Methods

This is a A cohort study. Data was collected from departments of Ain Shams university hospitals as colorectal department and oncology department.

Results

The overall post-closure complications in our study was 37.5%, there was no significant difference between the overall complications rate for both early and late closure groups (35% and 40%) respectively (P value 0.534), The majority of the complications were intestinal obstruction, and superficial surgical site infection, there was significant association between the interval to ileostomy reversal and the intestinal obstruction, it was higher in the late closure group, in the other hand the surgical site infection complication found to be not significantly higher in the early closure group than the late closure group (25% Vs 15%) with (P value 0.428).

Conclusion

Our study revealed that the duration between the creation of protective ileostomy and its reversal was not a significant independent predictor of post-closure complications rate. Depending on whether a patient has mild pre-closure complications and appears tolerant of the psychological effect of his stoma, the ileostomy closure can be deferred safely for a real indication such as completing adjuvant chemotherapy without concern that the longer duration to closure will increase the postoperative complications rate. We sincerely hope that our effort adds to the body of evidence until a consensus regarding the ileostomy closure timing is reached.
Vertical Axillary Incision for Treatment of Breast Outer Quadrants Tumors
Authors: Amer Hazem Abdelsalam Mohamed , Abdelmoty Kareem Fahmi , Shahrour Mohamed Ala'a Said , Elshiemy Mohamed Ahmed Fouad
Published: November 2024

Background

Breast cancer is the most common cancer among women. There is continuous annual improvement of the overall survival of breast cancer patients, with 5- year overall survival estimates increasing from 84.6% to 90.9% over the previous two decades. The upper outer quadrant of the breast is the most frequent site for breast cancer occurrence.

Aim of the Work

Is to evaluate the aesthetic satisfaction and oncological outcome of patients with breast outer quadrant tumors using single vertical axillary incision.

Patients and Methods

This prospective cohort study was carried out on 30 Patients who were histopathologically diagnosed with breast cancer in the upper lateral quadrant of the breast less than 5m and are eligible for breast conserving surgery between 18 and 45 years old - conducted at the breast cancer unit at Ain Shams University Hospitals.

Results

This study analyzed patients who underwent surgery for breast cancer. Most patients had no family history or co-morbidities. The mean age of patients was 38.8, with 86.7% having invasive ductal carcinoma. There was a moderate correlation between blood loss and drainage days. Patient and surgeon satisfaction with cosmetic outcome, recurrence, and other complaints was high, with 43.3%, 36.7%, and 20.0% rating the outcome as very good, excellent, and good, respectively.

Conclusion

The use of single vertical axillary incision in breast conserving surgery for upper lateral quadrant tumors was associated with high levels of patient and surgeon satisfaction with cosmetic outcome, recurrence, and other complaints. This technique can be a good option for eligible patients with breast cancer in the upper lateral quadrant of the breast less than 5cm. However, further studies with larger sample sizes and longer follow-up periods are needed to validate these findings.
Systemic Review and Meta-Analysis on the Surgical Complications in Breast Cancer Patients following Immediate Breast Reconstruction in Patients Received Neoadjuvant Therapy
Authors: Saied Ashraf El Zoghby El , Helmy Mohamed Ahmed , Abou El Naga Mohamed Ahmed , Rayan Mahmoud Talaat , Abd Allah Mohamed Hussein Makhlouf
Published: November 2024

Background

Breast reconstruction (BR) is a unique surgical procedure that provides patients undergoing mastectomy with significant psychosocial and aesthetic benefits and has also become a crucial part of the treatment pathway for women with breast cancer.

Aim and Objectives

The main aim of this study was to determine the surgical complications in breast cancer patients following immediate breast reconstruction and the effect of neoadjuvant therapy on the surgical complications.

Subjects and Methods

In this systematic review; we obtained 1,840 citations from the previously mentioned databases. We examined the titles and Abstracts of these references and excluded all the studies that were clearly ineligible for the analysis. For the remaining articles, we obtained full text copies for further evaluation. In the databases that we searched, we obtained 14 potentially eligible studies that examined the influence of NAC on immediate breast reconstruction. Twenty eligible studies addressed the influence of NAC on immediate breast reconstruction, and these studies also included extractable data; they were included in the review and meta-analysis

Results

A total of 149 donor site complications were founded among included studies and was in form of herniation, infection, hematoma, seroma, fat necrosis, bulging, wound problem, mastectomy skin flap necrosis, capsulectomy

Conclusion

Immediate breast reconstruction after NACT is a safe procedure with an acceptable post- operative complication profile. It may result in a slight increase in implant loss rates, but it does not delay commencing adjuvant therapy.
Evaluation of the Axillary Reverse Mapping Technique in Preventing Breast Cancer-Related Post Operative Lymphedema, Ain Shams University Initial Experience
Authors: Qayed Mohamed Fathi Ali Ali , Elshekh Rania ALAhmadi , Ayoub Bishoy Refaat Ragheb , Maher Amira , Fahmy Karim
Published: November 2024

Background

Management of breast cancer patients with clinically positive nodes is a field of research and axillary lymph nodes dissection is still an acceptable option for them. However it affects the patient quality of life in the form of breast cancer related lymphedema. Axillary reversed mapping technique is used to spare the arm lymph nodes during Axillary surgery aiming to reduce the rate of breast cancer related lymphedema.

Objective

To study the feasibility of using patent blue dye to perform axillary reverse mapping procedure in breast cancer patients with positive axillary lymph nodes scheduled for axillary lymph node dissection.

Patients and Methods

A prospective study including 20 patient with clinically positive axillary lymph nodes planed by MDT Committee at Ain Shams university hospital to perform axillary lymph nodes dissection.

Results

Identification rate of lymphatics and lymph nodes was 75% and 80% respectively and 60% of the stained LNS were seen below the axillary vein and lateral to the thoracodorsal bundle. Correlation between identification rate of the lymphatics and the lymph nodes with regard to N-staging and Neoadjuvant therapy wasn't statistically significant. BMI and number of lymph nodes removed were a confounding variables related to lymphedema.

Conclusion

Axillary Reverse mapping procedure using patent blue dye is simple idea to preserve arm lymph nodes and so, decreases the incidence of lymphedema, however there are a lot of variables related to lymphedema development which needs to be investigated well on larger group of patients and further multicentrs studies with long term follow up. The operative technique is quite challenging and need longer learning curve with well orientation to the axillary anatomy.