bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Serum Interleukin 36 in Egyptian Acne Vulgaris Patients versus Controls
Authors: Adel Shahin Maha Mohamed , Ahmed Soltan Marwa Yassin , Mahmoud Awaad Esraa
Published: October 2021

Background

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit, and it is one of the most common dermatological conditions worldwide. Some of the key mechanisms of pathogenesis are the disturbed sebaceous gland activity associated with excess sebum production and alterations in sebum fatty acid composition, dysregulation of the hormone microenvironment, interaction with neuropeptides, follicular hyperkeratinization, and induction of inflammation and dysfunction of the innate and adaptive immunity.

Objectives

We aimed to evaluate the serum IL36 levels in acne vulgaris patients in comparison with healthy controls and to correlate its level to different severities of acne vulgaris.

Patients and Methods

This is a case control study which included 30 acne vulgaris patients who were recruited from the Outpatient Dermatology Clinic at Ain Shams University Hospitals during the period between September 2018 and December 2018.

Results

The study revealed a highly significant increase in IL-36 serum levels which can differentiate cases form controls with a high degree of specificity of the test according to the ROC curve However, there was no association between IL-36 and the disease severity. Expression of high levels of IL-36 in all acne cases including mild cases suggests a probable role in early inflammatory stage of the disease. Furthermore, duration of the disease, body mass index, family history and sex were all insignificant factors on affecting IL-36 levels.

Conclusion

We found that IL-36 is involved in acne pathogenesis and its serum levels are elevated even in mild cases with comedonal lesions suggesting the possible involvement in the early events of acne vulgaris. Further studies are required to demonstrate more detailed explanation of IL-36 pathogenic role in acne.
Identification of Malassezia Species in Seborrheic Dermatitis Patients by CHROM Agar-Medium
Authors: Abd Alnaeem Sallam Mohamed , Taha Mahmoud El-sayed Mohamed , Abd Elfattah Afify Ahmed , Nooruldeen Abdulqader Mustafa Mustafa
Published: October 2021

Background

Seborrheic dermatitis (SD) is a subacute or chronic superficial inflammatory skin condition, characterized by pruritic, erythematous plaques with greasy, yellow-gray scales, which appear on areas rich in sebaceous glands such as the face, scalp, upper chest, and back.

Aim of the Work

To identify Malassezia species that are involved in the development of SD in different body sites (face, scalp and trunk) and in different age groups, by using Chrom agar.

Patients and Methods

Forty nine patients with seborrheic dermatitis attending dermatology outpatient clinic in Ain shams university hospital the samples collected from December 2018 to June 2019.

Results

In this study, the most affected areas were the scalp and other sites as face and ears, which is concordant with the majority of studies worldwide. The role of sex in propensity to the development of Malassezia spp. Infection in SD is still unclear.

Conclusion

The distribution of Malassezia spp. on healthy and diseased skin shows significant variation and differences, although our knowledge of Malassezia yeasts has increased tremendously during the last two decades, their pathological roles remain ambiguous, and there is currently no conclusive evidence that any given species is responsible for a specific disease.
Evaluation of the efficacy of homologous autoinoculation therapy in treatment of multiple recalcitrant warts
Authors: Abdelmonaem Nisreen Abbas , Adel shaheen Maha , Foad Tamer Mohsen , Elhusseiny Rania Mahmoud
Published: October 2021

Background

Warts are infections caused by human papillomavirus (HPV). There are new trends towards the use of immunotherapy in treatment of warts. Homologous autoinoculation is a minimally invasive procedure, which treats warts by stimulating a specific immune response against HPV

Objective

To evaluate the efficacy of autoinoculation therapy in treatment of multiple recalcitrant warts.

Methods

Under local anesthesia and aseptic condition, inoculum was collected by paring a wart by scalpel and by pressing it between two sterile glass slides. After making a subcutaneous Pocket in non-dominant forearm, the inoculum was introduced in the subcutaneous pocket with forceps and dressed. Follow up for 1,2,12 and 16 weeks was done.

Results

Fourty patients were included. At 12 weeks of therapy 42.5% showed complete clearance, 27.5% showed moderate clearance, 15% showed mild clearance and 12.5% showed treatment failure. No significant complication was documented after 1 and 2 weeks of follow up except in 3 patients in form of mild inflammation and mild pain. There was no recurrence at16 weeks follow up session.

Conclusion

Autoinoculation is simple and effective method in treatment of different types of warts including genital wart. It also prevents recurrence.
Measurement of Serum Elafin Protein in Psoriasis Vulgaris Patients Before and After Narrowband Ultraviolet (NB-UVB) Therapy
Authors: Abdulazeez Albarazenji Nisreen Fathi , El Naeem Sallam Mohamed Abd , Elhusseiny Rania Mahmoud
Published: October 2021

Background

Psoriasis is a common immune-mediated disease of the skin, mostly characterized by red, scaly, sharply demarcated, indurated plaques. The immunopathogenesis of psoriasis is not fully understood as it is the result of a complex interaction between genetic, environmental and immunological factors. Furthermore, a large body of evidence has identified a dysregulated interplay between keratinocytes and infiltrating immune cells underlying cutaneous inflammation in psoriasis. Cytokines and other soluble factors such as antimicrobial peptides (AMPs) secreted by resident or infiltrating cells are essential elements in this process of cell-cell communication.

Objective

To measure serum level of elafin protein using ELISA technique in psoriasis vulgaris patients before and after narrowband ultraviolet therapy and detect its correlation with psoriasis severity.

Subjects and Methods

Sixty subjects; 30 patients with psoriasis vulgaris and 30 age and sex matched apparent healthy controls were included. Each patient was subjected to a detailed history taking and examination beside calculation of PASI score before and after treatment. Blood samples were also taken from all subjects to assess serum Elafin level by ELISA technique before and after treatment. NB-UVB treatment sessions were given for the patients group three times per week for 3 months.

Results

There was a highly significant correlation between serum Elafin level and PASI scores among patients with psoriasis before and after treatment, which indicates that serum Elafin level could be used as a diagnostic marker for psoriasis severity and a prognostic marker for different psoriatic treatments.

Conclusion

In conclusion measurement of serum Elafin protein level could be considered as a diagnostic and prognostic marker for psoriasis activity and a useful tool for evaluating the efficacy of treatment.
Effect of Narrow Band Ultraviolet B Therapy on Tissue Levels of Interleukin-33 in Egyptian Vitiligo Patients
Authors: Mohamed Salem Samar Abdallah , Samir Ahmed Naglaa , Yassin Ahmed Marwa , Mohamed Seoudy Wael , Ahmed Ahmed Omar Mohamed
Published: October 2021

Background

Vitiligo is an acquired pigmentary disorder of unknown etiology, affecting approximately 1 % of the world population, without predilection for race or sex. It is characterized by white macules and patches, whose size increases over time, due to the loss of melanocytes. Vitiligo can appear at any time, and it significantly impairs the patients’ quality-of-life.

Objectives

The aim of the work was to study the influence of the NB-UVB radiation therapy on tissue level of IL-33 in patients with vitiligo.

Patients and Methods

This prospective study was carried out on 10 patients diagnosed as having non -segmental vitiligo stable for 6 months duration. All patients were selected from the dermatology outpatient clinic of vitiligo, Ain-Shams University Hospitals. All patients were subjected to full history taking, general examination and dermatological examination. The disease characteristics of vitiligo were recorded as regards stability, duration and extent of vitiliginous lesions. The activity of the disease was evaluated according to VIDA score, and the disease severity was evaluated according to VASI score. Digital photographic documentation was done.

Results

Hydropic degeneration of lower epidermis was also detected in (40%) of them and apoptotic keratinocytes were found in (10%) of them. After therapy, these inflammatory changes were significantly reduced this can be partially explained by immunosuppressive properties of NB-UVB as it is believed to cause a reduction of T cells by inducing apoptosis and impairs in-vitro antigen presentation by both murine DCs and human Langerhans cells. The main limitation of our study was the small cohort of the studied patients. Further large-scale studies are needed. Investigatory techniques other than immunohistochemical analysis may be also used to evaluate abnormalities of keratinocytes in vitiligo skin.

Conclusion

We concluded that NB-UVB has no effect on tissue expression of IL-33 and and that NB-UVB was effective in treating vitiligo as manifested by VASI score change after treatment with NB-UVB. Based on our results we recommend further studies with larger sample size and studying the effect of treatment on IL-33 expression in active vitiligo cases is also recommended.
Split Face Comparative Study of Plasma Gel versus Non Cross Linked Hyaluronic Acid for Treatment of Static Forehead Wrinkles
Authors: El Kahky Hanan , Hassen Samah Ibrahim , Salman Saja Dawood
Published: October 2021

Background

The entire human body is subject to changes associated with aging. Those occurring in the skin are visible, facial aging can be particularly negative since it represents the main image. Among the factors playing an important role in facial aging are exposure to ultraviolet (UV) light, smoking habits and alcohol consumption, which, together with genetic factors, can alter the rate of skin aging.

Objectives

The presented study aimed to compare the efficacy of the plasma filler and the non-cross linked hyaluronic acid in treating static forehead wrinkles.

Patients and Methods

The present study is a prospective study which included 20 adult male and female with different grades of static forhead wrinkles. Our participants range between 40 to 55 years old. This study was done in a period of 6 months starting from February 2019 to September 2019. All participant signed informed consent after explaining to them the objective of the study. An official research approval was granted from research ethical committee, faculty of medicine in Ain Shams University and fulfilled all the ethical aspects required in human research.

Results

So the plasma gel is as safe and efficient as non cross linked hyaluronic acid in treating static forehead wrinkles as there is no significant difference between the right and left forehead after treatment.

Conclusion

Plasma gel is as safe and effective as non cross-linked HA, plasma gel is cheap, available, easy promising tool to treat wrinkles.
Trichoscopy (Hair and Scalp Videodermoscopy) in the Healthy Egyptians Female. Norms for Measurable Parameters
Authors: Moneib Hoda Ahmed , Zaki Marwa SalahEldin , Ahmed Suzan Abdulkader
Published: October 2021

Background

Trichoscopy is a noninvasive diagnostic tool that allows the recognition of morphologic structures not visible by the naked eye. The aim of this study was to standardize the videodermoscopy method and to establish the norms for measurable parameters of normal Egyptian hair in females. The current study included 90 healthy Egyptian females between 18 and 50 years of age.

Objective

Our study revealed that there was a highly statistically significant difference between average number of hair in each of frontal and occipital areas and number of hairs in temporal area. The difference between number of hairs in frontal and occipital area was statistically significant.

Patients and Methods

The study included 90 volunteer Egyptian females with age ranging from 18-50 years, during the period between February 2018 till May 2019.

The study protocol

Was approved by Faculty of Medicine, Ain Shams University, Research Ethics Committee (FWA 000017585). The volunteers gave a written consent to participate in the work after explanation of the technique and study performed.

Volunteers

The group under study was selected from patients visiting dermatology clinic at Ain Shams University hospital due to nonhair related conditions, who never complained of excessive hair shedding and who had no early hair loss cases by family history. They were subjected to careful clinical inspection and pull test.

Results

Average hair shaft thickness showed a highly statistically significant difference between frontal area and each of temporal and occipital areas. Percentage of thin, mediumsized and thick hairs in frontal, occipital and temporal areas revealed that there was a highly statistically significant difference between percentage of thin hairs in each of frontal and temporal areas and in occipital area, a highly statistically significant between percentage of mid hairs in frontal area and in each of temporal and occipital areas, and a highly statistically significant difference between percentage of thick hairs in frontal area and in temporal area.

Conclusions

Norms of measurable parameters can be established using trichoscopy (hair and scalp videodermoscopy). Our results indicate that for healthy adult Egyptian females, not only are the average hair diameters and densities different in the different scalp regions, but also the contribution of thin and thick hairs, as well as follicular units. Better understanding of the norms in clinical practice will help to detect what is abnormal in hair and scalp videodermoscopy.
Lymph node status assessment in head and neck squamous cell carcinoma in patients with clinically non palpable lymph nodes: Meta-analysis
Authors: Riad Hany , Ibrahim Samer , Gouda Amr , Mustafa Ossama , Mohamed Heba
Published: October 2021

Background

The most important prognostic factor in squamous cell carcinoma of the head and neck (HNSCC) is the presence or absence of clinically involved neck nodes. The presence of metastases in a lymph node is said to reduce the 5-years survival rate by about 50%. The appropriate diagnosis of the presence of metastatic node is very important for the management of HNSCC

Aim

To compare difTerent diagnostic modalities for assessment of the clinically non palpable lymph nodes in HNSCC including by meta-analysis: CT, MRI, US, USFNAC and PET/CT for the proper cervical lymph node staging.

Methods

Met-analysis study on patients with HNSCC of clinically non palpable lymph nodes (cN0).

Results

Analysis was divided in 6 groups .Each group contain analysis of one modality according to available studies per patient, per level and per lesion .US is fair test per patient and per lesion.CT is good test per patient and excellent test per lesion.MRI is poor test per patient and fair test per lesion.CT-MRl combined is fair per patient and excellent per level.PET/CT is good per patient, fair per lesion and excellent per level. USFNAC is excellent per lesion.

Conclusion

CT, CT-MRI combined, PET/CT and USFNAC proved to be excellent in detecting cN0.MRI was poor test in detecting cN0.US was a fair test in detecting cN0 if used alone.
Bleeding Tendency in People Anesthetized with Sevoflurane Vs Isoflurane
Authors: Elsamny Talaat , Shoukry Tamer , Nageeb Mohamed , Salem Mohamed Elsayed
Published: October 2021

Background & Purpose

The effects of desflurane and sevoflurane, two commonly used inhalation anesthetics for the maintenance of general anesthesia, on peri- and postoperative bleeding is a focus of interest. This study conductd to evaluating that; Sevoflurane can cause bleeding tendencies more than Isoflurane anesthesia or not?

Study design

Prospective, randomized comparative study.

Setting

Ain shams university hospitals.

Subjects

We included 40 tonsillectomy patients (age from 2 – 12 years old), and classified them according to the anesthetic drug used into 2 independent groups: Isoflurane group (20 patients) and Sevoflurane group (20 patients).

Methods

All patients were subjected to full history taking, oral cavity examination, anterior rhinoscopy nasal examination, basic laboratory studies for bleeding tendencies (e.g. platelets and INR), adenoidal-tonsillectomy operational data (including operative time calculation), bleeding outcomes (blood loss and packs of blood transfusion) will be recorded, and half of the cases will be anesthetized with sevoflurane and another half with isoflurane.

Results

In the studied population, the mean age of all patients was (7.1 ± 2.7) years, with (57.5%) of patients were males; while (42.5%) were females. Regarding bleeding outcome data; the average blood loss of all patients was (15.5 ± 3.7) cc, and the average packs used were (4.2 ± 1.1).

We found a significant decrease in operative time in the Isoflurane group; compared to the Sevoflurane group (p = 0.0017). Regarding Bleeding outcome data; we found, a significant decrease in blood loss, in the Isoflurane group; compared to the Sevoflurane group (p = 0.00014), and a significant decrease in the number of packs used, in Isoflurane group; compared to Sevoflurane group (p = 0.0018).

Conclusion

To conclude, anesthesia with isoflurane can lead to a lower amount of intraoperative bleeding compared with sevoflurane. Therefore, isoflurane may be preferred as an inhalational agent for the maintenance of general anesthesia during tonsillectomy and adenoidectomy operations.
Construction of auditory bombardment therapy program: a pilot study
Authors: Rifaie Nahla Abd-ElAziz , Elrefaie Dina Ahmed , Mahmoud Mona Mosaad
Published: October 2021

Background

Speech sound disorder is a communication disorder in which children have persistent difficulty saying words or sounds correctly. It refers to any difficulty or combination of difficulties with perception, motor production, or phonological representation of speech sounds and speech segments.

Aim of the Work

to construct an Arabic auditory bombardment therapy program and measure its effectiveness in treatment of functional speech sound disorder.

Subjects and Methods

This study was applied on 60 participants divided into 2 groups (30 for each group) with age ranging from 3-5 years diagnosed with functional speech sound disorder with or without language disorders, attending at the Phoniatrics outpatient clinic in Ain Shams University Hospitals.

The test for identification of phonological processes was applied on 60 patients with speech sound disorder selected to participate in this study. These were divided in to 2 groups (Group (1) received only the conventional therapy while group (2) received auditory bombardment in addition to the conventional therapy for 3 months) and the test was repeated again after therapy.

Results

Group (2) showed high significant difference (improvement) in consonant assimilation, voicing change, final consonant deletion, palatal fronting, gliding, lateralization and glottal replacement while group (1) showed high significant difference (improvement) in syllable deletion and partial cluster reduction.

Conclusion

The present study showed that application of auditory bombardment therapy program in addition to conventional therapy has high significant improvement than conventional therapy alone.
Factors Affecting Adherence to Medications among Type2 Diabetic Patients Attending Primary Health Care Center in Cairo
Authors: Salama Hemat AbdEl-Salam Ahmed , Shaltoot Heba MohamedHamed , Abdul-Rahman Samia Ahmed , Abd El-Hamid Diaa Marzouk
Published: October 2021

Background

Poor adherence to medications is a major public health problem. Non-adherence results in disease progression, reduced functional abilities, a lower quality of life, waste of medication and increase use of medical resources such as nursing homes, hospital visits and hospital admissions.

Objective

To measure the prevalence and factors affecting adherence to medications among T2DM patients attending primary health care center of Saraya El Quobba. To measure the agreement between MTA (Measure Treatment Adherence) and ARMS (Adherence to Refills and Medications Scale) questionnaires as a tool of measurement treatment adherence.

Methods

A Cross sectional study was carried out in family medicine center of Saraya El Qubba in Cairo on 130 participants who had been diagnosed T2DM at least3 months before. Patients with T1DM, Patients with known history of psychiatric illness or cognitive impairment, Patients with communication problems such as aphasia, severe hearing or visual impairment were excluded. Selection of participants was done through Systematic Random Sampling. Data about adherence was collected using structured questionnaires MTA (Measurement Treatment Adherence) and ARMS (Adherence to Refills and Medications Scale) questionnaires.

Results

62.6% of our sample were females, 38.9% belonged to age group of 60 -70 years, 71.8% were married, 29% had intermediate education, 61.8% were unemployed. The level of adherence among patients attending primary health centre of Saraya El Quobba was 65.6%. Many factors were found to affect medication adherence as regular monitoring of blood glucose level (76.7%), regular follow up visit (75.9%), presence of family support (20.6), monthly income (84.2%) and educational level. There was a statistically significant strong negative correlation between the 2 measurements scores (r=-0.8644, p < 0.001).

Conclusion

The level of adherence was high among the participants in the current study. Many factors were found to affect medication adherence as regular monitoring of blood glucose level, regular follow up visit, presence of family support, monthly income, both high and low educational level. Agreement between to questionnaires was found.
Serum lactae level as an indicator for leakage in pediatric intestinal anastmosis
Authors: Hassan Yasser Abd El Rehim , Shafi'I Ihab Abd Al Aziz El , Asmar Khaled Mohamed Abd Al Salam Al , Ahmed Mohamed Hisham , El Aziz Ahmed Abd El Rahman Mousa Abd
Published: October 2021

Background

Its quite well know that high levels of serum lactic acid correlates with poor general condition and poor surgical outcome. Postoperative elevated serum lactate during the first 24h is associated with morbidity and even mortality in patients undergoing elective abdominal surgeries. In this study we need to compare the effect of fluctuation in serum lactate levels pre and postoperative on particularly instestinal anastmosis healing between elective vs emergency patients.

Objective

This study is designed to identify if high pre-operative lactate levels and post-operative lactate clearance are correlated with high risk of intestinal anatstmotic leakage in pediatrics.

Patients and Methods

This study was prospective observational study; conducted at Ain Shams University Hospital, Pediatrics surgery department and approved by the Ethical Research Committee at our hospital. We enrolled all patients (aged ≤ 14 years old) who were candidates for intestinal surgical anastomoses either elective or emergency. The patients included in our study were admitted post-operative at our department either in the intermediate or intensive care units accordingly. All patients with medical history of chronic kidney disease, liver failure, ICU admission or major surgery within the month prior to our study were excluded from our study.

Results

We enrolled 26 patients in our study who underwent intestinal anastomosis at our Pediatrics Surgery Department during the past six months. We had 7 female patients (26.9%) and 19 male patients (73.1%). The youngest was two-day old and the oldest was 14 years old. We had leakage incidence 38.5% of the studied patients. The cut-off lactate level for incidence of leakage is > 1.2 mmol/L for the 0h (Baseline reading), >2 mmol/L for the 6h, >1.4mmol/L for the 12h, >1.1mmol/L for the 18h, >1.3mmol/L for the 24h. The highest sensitivity and specificity are for the reading at 24h that had the highest sum of both sensitivity(90%) and specificity (93.3%) and area under curve (AUC) 0.860. All patients with elevated lactate > 1.4 mmol/L at 12 h had leakage (100% sensitivity) but with only 66.7% specificity.

Conclusion

This study shows that lactate levels during the first 24 hours postoperatively have a predictive value for postoperative intestinal anastomotic leakage after a laparotomy surgery. Serum lactate levels obtained 24 hours postoperatively had the best predictive value to discriminate between patients with and without anastomotic leakage. Although not explanatory by its design, our study demonstrates that elevated postoperative lactate is an ominous sign that should to be addressed by the intensivist. However, further studies are required to indicate which strategies aimed at resolving hyperlactatemia improve postoperative outcomes.
Laparoscopic Cholecystectomy after Endoscopic Retrograde Cholangiopancreatography
Authors: Shamy Prof. Dr./Abd El Ghany Mahmoud El , Farrag Dr./Ahmed Magdy Ahmed , Mohammed Ahmed Kamal Mohammed
Published: October 2021

Background

Laparoscopic cholecystectomy (LC) post Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy(ES) is generally accepted as the treatment of choice for patient with choledococystolithiasis. Previous studies have shown that LC after ERCP is associated with a high conversion rate. The aim of the present study was to assess the complexity of LC after ERCP compared with standard LC for symptomatic uncomplicated cholecystolithiasis.

Objective

s: So the aim of this study is to assess the complexity of LC post ERCP comparted to elective LC without previous ERCP.

Method

The study is a prospective cohort study of two groups of patients: patients who had undergone a previous ERCP for choledocolithiasis (PES) and patients with cholecystolithiasis who had no previous intervention prior to LC (NPES).

Results

The PES group consists of 25 patients and the NPES group consists of 25 consecutive patients, patients in the PES group had a higher risks for longer (more than 35 min) duration of operation, the conversion rate in the PES group and the NPES group (12% versus 0%, respectively) were not significantly different, duration of post-operative hospital stay in the PES group was longer than NPES group, there was more difficulty in achieving the critical view of safety in the PES group (easily achieved in 48%) than NPES group(easily achieved in 92%).

Conclusion

A laparoscopic cholecystectomy after ES is longer and more difficult than in uncomplicated cholelithiasis and should therefore be performed by an experienced surgeon.
Evaluation of Round Block Oncoplastic breast surgery in early Juxta-areolar breast cancer in comparison to conventional breast conservation surgery
Authors: El Moghny Ashraf Abd , Fahmy Karim , Mohamed Ahmed Khalil
Published: October 2021

Background

Breast cancer is the most common cancer in women all over the world representing 18% of all women reported cases of cancer. It represents the leading cause of women mortality as representing 23% of all women cancer deaths. The decision in any breast cancer patient is taken by MDT that includes breast surgery consultant, pathology consultant, plastic surgery consultant, radiology consultant and medical oncology consultant. Breast conserving surgeries are now the standard technique for management of breast cancer patient. Oncoplastic techniques are replacing SWLE for their better cosmetic outcomes and better exposure of the tumor.

Objective

The aim of this work was to assess the round block technique as regard oncological safety, surgical outcomes and patients' satisfaction comparing results with standard wide local excision.

Methods

This is a retrospective study to assess the round block technique as an oncological procedure for management of early breast cancer near to nipple-areola complex as regard oncological safety, surgical outcomes and patients' satisfaction comparing results with standard wide local excision. It was conducted at general surgery department, Ain Shams university hospitals. Approval of the Ethical Committee and written informed consent from all participants were obtained. In our study 40 breast cancer patients are subdivided into group (A) 20 females which underwent round block technique and group (B) 20 femaleswhich underwent standard wide local excision. Patient and tumor criteria including age, co morbidities, tumor size and distance between tumor and nipple-areola complex were considered to be nonsignificant between 2 groups so the only difference is the surgical technique.

Results

The study shows that the round block technique and SWLE have the same results regarding hospital stay, post operative complications and oncological recurrence with the advantage to RBT because of its better cosmetic outcomes. So, the round block technique is superior to SWLE in selected cases.

Conclusion

The round block technique has comparable post operative parameters with better cosmoses as it is scarless operation without nipple and areola shift suggesting that the round block technique is superior to SWLE in selected cases.
Impact of Roux-En-Y Gastric Bypass on Vitamin D and Iron Metabolism a Systematic Review Literature
Authors: Maaty Sameh Abdallah , Fawzy Fawzy Salah , Goda BahaaEldin Shokry
Published: October 2021

There has been a steady rise in the number of individuals who are morbidly obese. The divided RYGB is the most commonly performed bariatric surgical procedure in the world and is considered the gold standard. Physicians need to be aware of the important peri-operative complications that can occur after gastric bypass. In addition, gastrointestinal physicians are seeing patients who seek advice and care for symptoms that develop or persist after RYGB. Physicians should be able to predict and manage most postoperative medical and nutritional disorders related to RYGB and should be prepared to assess patients for potential referral for surgical intervention or revision
Systematic Review and Meta-Analysis of treatment of Palpable Undescended Testis
Authors: Abdallah Hassan Abdel Monem , El-Debeiky Mohamed Soliman , Nasser Amr Abdel Raouf Abdel
Published: October 2021

Background

Undescended testis is the most common endocrinological disease in the male newborn period. Incidence varies between 1.0% and 4.6% in full-term neonates, with rates as high as 45% in preterm neonates. Failure or delay of treatment can result in reduced fertility and/or increased testicular cancer risk in adulthood.

Aim and objectives

: To establish, through the available literature, which is the best technique, either hormonal therapy or surgical orchiopexy for treatment of palpable undescended testis through systematic review and meta-analysis.

Subjects and methods

: The review considered case-control studies, case report studies, and retrospective case follow-up evaluating the effectiveness or efficacy of a certain technique of treatment of palpable undescended testicles over other techniques either hormonal therapy and surgical orchiopexy according to age of the patient, This review considered all studies that involve infants with palpable undescended testicles, Search strategy is designed to include both manual and electronic data available. Electronic searches involved searching databases of PubMed (from Jan. 1987 till July 2017), EMbase, CINAHL and Cochrane database.

Results

The overall success rate of primary orchiopexy is 96.4% and the overall success rate for 2- stage FS is 86%.

Conclusion

There is good evidence for early placement of undescended testes in the scrotal position to prevent potential impairment of fertility and reduce the risk of testicular malignancy.
Pattern of intra-peritoneal intra-abdominal injuries in polytrauma patients admitted to general surgery department at El-Demerdash Hospital
Authors: Ahmed Ahmed Mohamed Kamal , Awad-Allah Mohammad Ahmad Abd-erRazik , Hermina Joseph Ellia Fahmy
Published: October 2021

Background

Severe or major trauma is a worldwide pandemic and one of the leading causes of death and disability. Polytrauma always involves young, productive individuals and represents a substantial burden on the society.

Aim of the Work

To detect the incidence and the pattern of intra-abdominal injuries in polytraumatized patients admitted to the general surgery department at El-Demerdash Hospital and to estimate the trauma burden in General Surgery Department Ain Shams University.

Patients and Methods

Retrospective study of records of polytrauma patients admitted to general surgery department at El-Demerdash Hospital from the period of January 2018 to June 2018.

Results

In the specified study period of 6 months from 1/1 /2018 to 31/6 /2018, the ER department of Ain Shams University hospital (El-Demerdash hospital) received 3,328 cases of trauma out of which 40 cases were admitted at General Surgery Department with incidence rate 1.2% of total polytrauma patients admitted in the hospital in various departments. There were 37.5% of patients with intra-abdominal collection with no documented organ injury. Most common intra-abdominal organ injured was spleen 17.5% then liver the largest intra-abdominal organ 5% and stomach 5%, least to be injured were bowel loops 2.5%.

Conclusion

Polytrauma is a major health problem and a major cause of death in Egypt. 40 trauma cases were admitted to general surgery department. 80% of them were males and 20% were females. The mean age of trauma victims was 33.3 years old. 42.5% of them had surgeries. The study recorded 7.5% fatalities.
Transversus Abdominis Muscle Release (TAR) for Posterior Component Separation during Major Abdominal Wall Reconstruction
Authors: Sabry Alaa Abbas , Elmaleh Haitham Mostafa , Abo-Elzem Hossam Attia , Rasmy Joseph Ezat
Published: October 2021

Background

Ventral hernia repair is one of the most common operations performed today, yet when complex and huge it presents a true challenge for the surgical team.

Aim of the Work

To assess the feasibility, safety and efficacy of Transversus Abdominis release technique in management of ventral hernia with large defects.

Patients and Methods

This study is a prospective interventional study conducted at Ain Shams University Hospitals on 40 patients diagnosed as having ventral hernia with a defect equal to or more than 10cm in width and operated upon between October 2018 and October 2019 with minimal follow up of 6 months postoperatively.

Results

40 ventral hernia patients were enrolled in the study. Mean operative time (in minutes) in TAR patient is 268.5min (4hr 28min) with SD ± 47.4. Postoperative pain evaluation using the visual analogue scale (VAS) score, the postoperative pain was assessed 48hrs postoperatively, the mean VAS score for TAR patient being (6.77 ± 1.70). Early Postoperative wound complications 10 (25.0%).

Conclusion

After this TAR technique are effective and reliable method in experienced hands.
A Comparative Study between Nissen's Fundoplication with or without Endoscopic Mucosal Resection in the Treatment of Barrett’s Oesophagus: a Meta-Analysis
Authors: Elfeky Khaled Abdallah , El-Hefny Amr Mohamed Mahmoud , Hossam-ElDin Ayman , Fathy Mark Medhat
Published: October 2021

Background

It is already known that Barrett’s esophagus (BE) is a premalignant condition in which the normal squamous epithelium of the distal esophagus is replaced by columnar epithelium (intestinal metaplasia or gastric metaplasia) due to GERD. Most observers believe that there is a progression from intestinal metaplasia to low-grade dysplasia (LGD) to highgrade dysplasia (HGD) to cancer. The relative risk of developing esophageal adenocarcinoma in patients with BE appears to be 30-fold higher. Conventional therapies include medical treatment (profound acid inhibition), endoscopic treatment (like endoscopic mucosal resection) and surgical treatment (fundoplication).

Methodology

Types of studies: Published studies about the efficacy of Nissen’s Fundoplication with or without Endoscopic Mucosal Resection in the treatment of Barrett’s Oesophagus (carried out in the period between 2015 – 2020), types of participants Patients with clinically proven Barrett’s Oesophagus diagnosed by endoscopy and biopsy, types of interventions Nissen’s Fundoplication (Open or Laparoscopic) with or without Endoscopic Mucosal Resection, types of outcome measures Outcome of treatment in the form of Complete Remission of Columnar Metaplasia of the oesophageal mucosa or regression in recurrence rate as proved by follow-up endoscopy.

Results

The strategy of endoscopic therapy for Barrett’s metaplasia, dysplasia and/or intramucosal cancer along with fundoplication results in similar durability and recurrence rates when compared to patients being managed with PPIs following endoscopic therapy. However, fundoplication along with endoscopic therapy is superior to either of them alone in preventing further progression of disease and the development of cancer, particularly in refractory patients.

Fundoplication is an important strategy along with endoscopic therapy for Barrett’s to achieve and maintain CR-IM, and to facilitate the eradication of persistent dysplasia.

Conclusion

Endoscopic mucosal resection after Nissen's Fundoplication is a safe modality, with high rate of success in complete eradication of BE in symptomatic GERD patients, especially those with severe anatomical impairment in distal esophageal segment. As a concurrent procedure, endoscopic procedures may be beneficial in the terms of reducing the early recurrence rates, which seems to be important issue during the management of BE. By doing synchronous endoscopic procedures and fundoplication, one might observe a true anatomy of esophagogastric junction in its entirety and might be able to truly observe the distal extent of columnar esophagus.
Early and Late Hypocalcaemia After Total Thyroidectomy Prospective Study
Authors: Ibrahim Emad EL-Deen Farid , Gazya Osama Mohamed Abdo Abo , Omran Hesham Mohamed Ali , Ali Amr Hamed Afifi , Gad Shenouda Mina
Published: October 2021

Background

Hypocalcaemia post total thyroidectomy, is one of the most common complication observed in patients who undergo bilateral thyroid resection. Although hypocalcaemia is self-limiting in most patients and does not require treatment, symptomatic hypocalcaemia is of particular concern. We aimed to evaluate the incidence of hypocalcaemia post total thyroidectomy with evaluation of serum calcium levels as a cheap and available method so we can identify patients at risk of postoperative hypocalcaemia who require supplementation treatment, and those not at risk who can be safely discharged without any supplementation treatment.

Objective

To assess the incidence of postoperative hypocalcaemia post total thyroidectomy wither it’s temporary or permanent.

Methods

prospective analysis of 100 patients undergoing total thyroidectomy. Preservation of parathyroid glands and their blood supply was attempted in all cases. The patients were assessed for manifestations of hypocalcaemia after thyroidectomy.

The assessment was done through: (1) monitoring the total and ionized calcium level 24 hours postoperatively, (2) Total and ionized calcium level was measured in the third week postoperative, (3) clinical examination and detection of symptoms and signs of hypocalcaemia, (4) In resistant cases assessment of total and ionized calcium and PTH at 3 and 6 months.

Results

The study included 87 females and 13 males, 37 was the mean age; 15 patients developed symptoms of hypocalcaemia (15%), 8 of them were asymptomatic but 7 of them developed symptoms, 85 patients did not develop any clinically manifested symptoms of hypocalcaemia (85%). all of them recovered from hypocalcaemia except 2 patients, one of them recovered at 3 months postoperative and the other one didn’t recover from hypocalcaemia so we diagnose it’s case as a permanent hypocalcaemia post total thyroidectomy.

Conclusion

Results of this study indicate that measuring calcium postoperative is a cheap and available lab investigation to indicate hypocalcaemia post total thyroidectomy, and as we mentioned before that we don’t need to prescribe calcium or vitamin D to all the patients underwent total thyroidectomy as an empirical treatment to prevent hypocalcaemia but we prescribe it just to patients developed symptoms of hypocalcaemia as it will be costly to the patient.
Classic versus High Lateral Tension Abdominoplasty in Post-bariatric Patients
Authors: Feky Kahled Abdallah El , Shoka Ahmed Ain , Estawrow Mina Agaiby , Mourice Mina Mamdouh
Published: October 2021

Background: Obesity is a chronic condition with a high prevalence and multifaceted etiologies; it is accompanied by an increased risk of morbidity and mortality. Bariatric surgeries (weight loss surgeries) include a variety of procedures performed on people who have obesity. Skin redundancy is a common post-bariatric complication. Abdominoplasty or "tummy tuck" is a cosmetic surgery procedure used to make the abdomen thinner and more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. This type of surgery is usually sought by patients with loose or sagging tissues after pregnancy or major weight loss. This study is a comparison between Classic and High lateral tension abdominoplasty techniques in treatment of abdominal skin redundancy in post bariatric patients.

In our research, we compared between two techniques of abdominoplasty in treatment of post bariatric abdominal skin redundancy, the classic technique and High Lateral Tension technique, the comparison was in patient satisfaction and in post operative complications

The study showed that patient satisfaction was higher in classic technique than the High lateral tension technique due to smaller and less apparent scar, while post operative complications were almost the same in both techniques

According to our study, we advise plastic surgeons to perform classic abdominoplasty technique in treatment of post bariatric abdominal skin redundancy.
A Comparative Study between Round Block Technique and Standard Wide Local Excision in Breast Cancer Patients
Authors: El-Naser Amr Abd El-Raouf Ali Abd , Ahmed Dina Hany , Mohamed Mohamed Shawky
Published: October 2021

Background

The goal of optimizing the cosmetic and oncologic outcomes of BCS has been addressed in recent years by the emergence of the field of oncoplastic surgery, that originally defined as an assortment of volume replacement techniques performed by plastic surgeons to replace all or part of the resected breast volume with myocutaneous tissue flaps. The definition of oncoplastic surgery has more recently been expanded to include a wide range of volume displacement or volume redistribution procedures performed by breast surgeons and general surgeons to optimize breast shape and breast volume following breast cancer surgery.

Aim of the Work

To assess the round block technique as regard oncological safety, surgical outcomes and patients' satisfaction comparing results with standard wide local excision.

Patients and Methods

This is a prospective randomized study to assess the round block technique as an oncological procedure for management of early breast cancer near to nipple-areola complex as regard oncological safety, surgical outcomes and patients' satisfaction comparing results with standard wide local excision. Twenty breast cancer patients are subdivided into group (A) 10 females which underwent round block technique and group (B) 10 femaleswhich underwent standard wide local excision. Patient and tumor criteria including age, co morbidities, tumor size and distance between tumor and nipple-areola complex were considered to be non-significant between 2 groups so the only difference is the surgical technique.

Results

The round block technique and SWLE have the same results regarding operative time, intra-operative blood loss and post operative complications with the advantage to RBT because of its better cosmetic outcomes and lower re-excision rates. So, the round block technique is superior to SWLE in selected cases.

Conclusion

The round block technique has comparable operative parameters to SWLE with no evidence of increased surgical complications. With a lower re-excision rates and better cosmoses were observed in the round block patients as it is scarless operation without nipple and areola shift suggesting that the round block technique is superior to SWLE in selected cases.
Early Versus Delayed Laparoscopic Cholecystectomy in Cases of Acute Calcular Cholecystitis
Authors: El-Din Mohammed Mohammed Bahaa , Halim Hany Rafik , El-Hamid Mohammed Abd El-Sattar Abd , El-Razek Mohammed Safwat Abd
Published: October 2021

Background

Acute cholecystitis (AC) is one of the important causes of abdominal pain on presentation to the emergency department. Early diagnosis and treatment of AC has a positive effect on morbidity and mortality. Laparoscopic cholecystectomy (LC) is an important approach for treating acute cholecystitis nowadays. Issued data indicated that approximately 917,000 and >50,000 LCs were annually performed to treat acute cholecystitis in the United States and England, respectively. Although LCs have been extensively performed to manage acute cholecystitis, the optimal timing of LC for this given condition is inconclusive.

Aim of the work

The aim of this study is to prospectively compare between early and delayed laparoscopic cholecystectomy as a management of acute calcular cholecystitis along with their operative and post-operative outcomes.

Patients and methods

From December 2019 to December 2020 in Ain Shams University Hospitals, a prospective randomized study was conducted over 20 patients of acute cholecystitis: 10 of them underwent laparoscopic cholecystectomy from 3 day to 7 day of symptoms of acute cholecystitis, and the other 15 after 6- 8 weeks. Operation time, intraoperative and postoperative surgical complications and duration of hospital stay were assessed and compared in the 2 groups.

Results

Although the operation time was longer in the group with early laparoscopic cholecystectomy, but the overall complications along with the total hospital stay were less in this group of patients.

Conclusion

Early timing of laparoscopic cholecystectomy in relation to the onset of gall bladder inflammation may reduce the conversion rate and the total complication rate. So, early laparoscopic cholecystectomy for patients with acute cholecystitis has both medical and socioeconomic benefits and it is the preferred approach in comparison to delayed approach.
Characterisation of Inflammatory Breast Cancer in Egypt
Authors: Talaat Ayman Ahmed , El-Shinawi Mohamed Sl-Sayed , Hafez Ramy Fouad , Nida Muhammad Abdulhalim Kamal
Published: October 2021

Background

Inflammatory breast cancer is a rare type of breast cancer, with a lower median age at diagnosis than other types of breast cancer. It is known that; the four molecular subtypes are shown in inflammatory breast cancer and they reveal the prognosis. However, no populationbased studies investigated these factors on Egyptian patients.

Methods

We searched the medical records at Breast Surgery Unit at Ain Shams University Hospitals to identify female patients diagnosed with IBC from July 2007 through June 2017. Data were scored, tabulated and statistically analyzed.

Results

The median age was 47 years. LNs were affected in all patients. Grade III tumors were higher at younger age. Higher incidence of hormonal negative and HER2 positive tumors with prevalence at younger age group.

Conclusions

IBC is an aggressive disease affecting Egyptians at younger age with prevalence of hormonal negative, HER2 positive and triple negative subtypes.